The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke


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If adhesive strips are used, keep them dry and they will fall off within a few days. You may go back to your normal diet unless your healthcare provider tells you otherwise. It is generally advised to follow a diet that is low in fat and cholesterol. You should eat vegetables, fruits, low-fat or non-fat dairy products, and lean meats. Avoid foods that are processed or packaged.

Brain Bypass Procedure

When you see the signs, you k now you need to call fast. Your healthcare provider may give you other instructions after the procedure, based on your situation. Health Home Treatments, Tests and Therapies. Why might I need a carotid endarterectomy? Your healthcare provider may have other reasons to advise a carotid endarterectomy.

What are the risks of a carotid endarterectomy? Some possible complications of carotid endarterectomy include: Stroke or TIA Heart attack Pooling of blood into tissue around the incision site causing swelling Nerve problems with certain functions of the eyes, nose, tongue, or ears Bleeding into the brain intracerebral hemorrhage Seizures uncommon Repeated blockage of the carotid artery.

Or new blockage that develops in the artery on the other side of your neck. Bleeding at the incision site in the neck Infection High blood pressure Irregular heart beat Blocked airway from swelling or from bleeding in the neck If you are allergic to or sensitive to medicines, contrast dye, iodine, or latex, tell your healthcare provider.

Bypassing Trouble

How do I get ready for a carotid endarterectomy? Your healthcare provider will explain the procedure to you and you can ask questions. You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.


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Your healthcare provider will review your health history and do a physical exam to make sure you are in otherwise good health before having the procedure. You may have blood tests or other diagnostic tests. Tell your healthcare provider if you are sensitive to or are allergic to any medicines, iodine, latex, tape, contrast dye, or anesthesia.

Tell your healthcare provider of all prescription and over-the-counter medicines and herbal supplements that you are taking. Tell your healthcare provider if you have a history of bleeding disorders. Also tell your provider if you are taking any blood-thinning medicines anticoagulants , aspirin, or other medicines that affect blood clotting. You may be told to stop some of these medicines before the procedure. If you are pregnant or think you could be, tell your healthcare provider.

Follow any directions you are given for not eating or drinking before surgery. Your healthcare provider may request a blood test before the procedure to find out how long it takes your blood to clot. You may get medicine sedative before the procedure to help you relax. Tell your healthcare provider if you have a pacemaker. If you smoke, stop smoking as soon as possible before the procedure. This may help you recover faster.

It may also improve your overall health status. Smoking raises the risk for blood clots.. Based on your condition, your healthcare provider may give you other directions for getting ready. What happens during a carotid endarterectomy? Generally, carotid endarterectomy CEA follows this process: You will be asked to remove any jewelry or other objects that may interfere with the procedure.

STA-MCA Surgery for Moyamoya Disease

You will remove your clothing and put on a hospital gown. You will be asked to empty your bladder before the procedure. An IV intravenous line will be started in your arm or hand. Another catheter will be put in your wrist to monitor your blood pressure and to take blood samples. One or more extra catheters may be put in into your neck, opposite the surgery site, to monitor your heart. Other sites for the catheter include the under the collarbone area and the groin.

If there is too much hair at the surgical site, the healthcare team may shave it off. You will be placed on the operating table, lying on your back. Your head will be raised slightly and turned away from the side to be operated on. A catheter will be put in into your bladder to drain urine. The anesthesiologist will check your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. CEA may be done under local anesthesia.

You will be sleepy, but will not feel the area being operated on. You will get a sedative in your IV before the procedure to help you relax. This lets the healthcare provider monitor how you are doing during the procedure by asking you questions and testing your hand grip strength. If the CEA is done under local anesthesia, the healthcare provider will give you constant support and keep you comfortable during the procedure. You will get pain medicine as needed. Under local anesthesia, you will get oxygen through a tube that fits in your nose.

A CEA may also be done under general anesthesia. This means you will be asleep. Once you are sedated, the provider will put a breathing tube into your throat and into your windpipe to provide air to your lungs. You will be connected to a ventilator. This machine will breathe for you during the surgery. You will be given a dose of antibiotics through your IV to help prevent infection.

The healthcare team will clean the skin over the surgery site with an antiseptic solution. The healthcare provider will make a cut incision down the side of the neck over the diseased artery. Once the artery is exposed, the provider will make a cut into the artery. The healthcare provider may use a device called a shunt to divert blood flow around the surgery area.

This will keep blood flowing to the brain. A shunt is a small tube that is put into the carotid artery to send blood flow around the area being operated on.

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In the high-flow setting, the initial anastomosis was performed distally between the intracranial recipient artery and the outflow end of the vein graft in an end-to-side fashion. Elliptical arteriotomy was performed to match the diameter of the vein graft, and the lumen was flushed with heparinized solution.

End-to-side anastomosis began on the posterior wall followed by the anterior wall of the recipient vessel, using interrupted nylon sutures. Blood flow through the recipient artery after anastomosis served to untwist the vein graft and allow for the better assessment of the vein graft length required to reach the donor artery.

Standard end-to-end anastomosis was performed using a double clamp and interrupted or nylon sutures between the vein graft and the donor artery. The adventitia was routinely stripped from the vein graft, allowing for adequate pulsatile flow and facilitating flow from the STA through the graft. In the case of low-flow bypass, the plastic surgeon performed a direct bypass between the donor artery and recipient intracranial vessel using end-to-side anastomosis as described above.

The dura was repaired and tented, the calvaria was fixed with miniplates, and the burr holes were enlarged to accommodate the bypass and to prevent any compression.

The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke
The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke
The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke
The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke
The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke
The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke
The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke The Extra-Intracranial Bypass Operation for Prevention and Treatment of Stroke

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