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Richard Leblanc, Jane L. Tyler, Gérard Mohr, Ernst Meyer, Mirko Diksic, Lucas Yamamoto, Laughlin Taylor, Serge Gauthier and Antoine Hakim

C erebral revascularization by superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis has been performed for the treatment of patients with focal cerebral ischemia due to atherosclerotic cerebrovascular disease that is not amenable to endarterectomy. Pre- and postoperative evaluation of such patients by means of positron emission tomography (PET) affords an opportunity to study the hemodynamic and metabolic consequences of chronic cerebral ischemia, as well as the effects of revascularization. This study reports the effects of STA

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John R. Little, Anthony J. Furlan and Bernadine Bryerton

A branch of the superficial temporal artery (STA) or the occipital artery (OA) is usually used as the donor artery for cerebral revascularization. These arteries are relatively long and usually have a luminal diameter of 1 to 2 mm at the site of anastomosis. 14 Recent reports indicate that these arteries frequently have substantial arteriosclerotic changes in the older age group, when cerebral revascularization is usually indicated. 7, 12 These pathological changes could potentially reduce the efficacy of the procedure. In some instances, the scalp artery

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Marcus Czabanka, Peter Vajkoczy, Peter Schmiedek, and Peter Horn

M oyamoya disease occurs with a 2-peak incidence with a large peak in the first decade of life (pediatric MMD patients) and another peak in young adults (adult MMD patients). According to this age-dependent distribution of MMD, the clinical presentation of pediatric and adult MMD patients has been considered to be different. 5 , 7 Despite different clinical presentations, surgical revascularization represents the treatment of choice for both patient populations. 20 However, there are several different revascularization procedures available; they can be

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Shiro Kashiwagi, Shoichi Kato, Shinko Yasuhara, Yukio Wakuta, Tetsuo Yamashita and Haruhide Ito

indirect anastomosis procedures, such as encephaloduroarteriosynangiosis (EDAS) 8 and encephaloarteriosynangiosis (EAS), 7 branches of the scalp arteries, most often obtained from the superficial temporal artery (STA), are used as donor arteries. Therefore, the area of revascularization is limited to the anatomical distribution of these arteries. To increase the area of revascularization, other techniques, such as encephalomyosynangiosis (EMS) 14 or omental transplantation, 5 are usually combined with these procedures. Dural arteries are potential donor arteries

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Nnenna Mbabuike, Kelly Gassie, Benjamin Brown, David A. Miller and Rabih G. Tawk

T he most recent trials regarding the acute management of stroke have highlighted that treatment with endovascular therapy is associated with better functional outcome at 90 days. 23 Of the 5 recent stent retriever trials, all but one (SWIFT PRIME) included patients with proximal carotid artery stenosis or occlusion, yet the number of patients and exact technique of revascularization was not consistently reported. 23 Outcome in this subgroup was reported in 2 trials (ESCAPE and MR CLEAN) to be promising, but the application of those results is limited by

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Raphael Guzman, Marco Lee, Achal Achrol, Teresa Bell-Stephens, Michael Kelly, Huy M. Do, Michael P. Marks and Gary K. Steinberg

US found an annual incidence of 0.086/100,000 persons. 43 The numbers are much lower than those reported for the Asian population, with the newest data in that population reporting an incidence of 0.54/100,000/year and a prevalence of 6/100,000. 28 Outcomes after surgical treatment of adult and pediatric patients with MMD 11 , 25 , 37 and moyamoya syndrome (that is, secondary moyamoya phenomenon associated with a syndrome) 19 , 37 have been previously reported. However, most large series are found in the Asian literature where direct revascularization

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Fernando G. Diaz, Angeline R. Mastri, James I. Ausman and Shelley N. Chou

acute cerebral revascularization performed 4 and 24 hours after regional cerebral ischemia in the dog. Materials and Methods Twenty-eight old mongrel dogs whose age was determined by the characteristics of their dentition, gingival mucosa, and fur, and of weights varying from 14 to 18 kg were obtained. All animals were subjected to an initial neurological examination. 12 Only those animals with completely normal neurological grading and without signs of systemic disease were accepted into the study. Anesthesia was induced with one intravenous dose of sodium

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Muhammad Zeeshan Memon, Sabareesh K. Natarajan, Jitendra Sharma, Marlon S. Mathews, Kenneth V. Snyder, Adnan H. Siddiqui, L. Nelson Hopkins and Elad I. Levy

, we describe the off-label, compassionate use of intraarterial eptifibatide in patients with ischemic stroke who developed reocclusion after recanalization or formed fresh thrombi in distal vessels that were inaccessible using endovascular devices. Methods Patient Selection Patients who received intraarterial eptifibatide as an adjunct during endovascular acute ischemic stroke revascularization at our center between January 2005 and December 2008 were identified from a prospectively collected database. All patients were selected for endovascular therapy

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Nancy McLaughlin and Neil A. Martin

M oyamoya disease is a chronic disease characterized by progressive stenosis of the distal internal carotid artery and its branches with the gradual development of fragile collateral vascularization. Surgical treatments aim to revascularize the ischemic brain parenchyma by establishing collaterals from ECA branches to the internal carotid artery territories. Surgical options include direct anastomosis from the frontal or parietal branch of the STA to the MCA as a recipient branch. The occipital artery can also serve as donor artery if the STA is too tiny

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Eric S. Nussbaum, Kevin M. Kallmes, Jeffrey P. Lassig, James K. Goddard, Michael T. Madison and Leslie A. Nussbaum

challenging lesions can be managed using parent artery occlusion combined with creative forms of cerebral revascularization to maintain adequate blood flow to the distal vascular territory. 1–9 As the indications for endovascular therapy widen, maintaining highly specialized centers that provide a full range of endovascular and surgical approaches, including cerebral revascularization, is necessary to ensure that complex aneurysms can be addressed adequately. This report details our experience with cerebral revascularization procedures in a large series of complex IAs for