An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS)

Search Article
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Advertise Subscribe Contacts Login  Facebook Tweeter
  Users Online: 836 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
Year : 2020  |  Volume : 15  |  Issue : 3  |  Page : 499-506

EC-IC Bypass; Our experience of cerebral revascularization with intraoperative Dual-Image Video Angiography (Diva)

1 Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan; Department of Neurosurgery, Apollo Specialty Hospital, Bengaluru, Karnataka, India
2 Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
3 Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan; Department of Neurosurgery, Government Medical College, Thrissur, Kerala, India

Correspondence Address:
Dr. Girish Joshi
Department of Neurosurgery, Apollo Specialty Hospital, Jayanagar 3rd Block, Near Madhavan Park, Bengaluru - 560 011, Karnataka, India

Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_84_20

Rights and Permissions

Background: Extracranial-intracranial (EC-IC) arterial bypass has been used in the treatment of various cerebrovascular ischemic disease due to atherosclerosis or Moyamoya disease, skull base tumors encasing large IC artery or complex IC aneurysms. Aim: The aim is to analyze surgical technique (EC-IC bypass) and its outcome with intraoperative use of dual image video angiography (DIVA) and Doppler ultrasound. Materials and Methods: We studied in this article a series of 23 patients operated in Banbuntane Hotokukai Hospital, Fujita Health University, for which a superficial temporal artery-middle cerebral artery anastomosis was done for steno-occlusive disease, giant IC aneurysm or Moyamoya disease. The study was conducted between 2018 and 2020. We used dual-image video angiography (DIVA) and Doppler ultrasound to assess the luminal patency of anastomosis during the procedure. Results: In this study, three patients presented with Moyamoya disease, 4 had aneurysm, whereas 16 patients presented with the vascular steno-occlusive disease. The patients were divided into three categories (steno-occlusive disease, Moyamoya, and flow replacement for giant aneurysm). Dual image video angiography, along with intraoperative Doppler, helped us in the assessment of luminal patency of the anastomosis. Conclusion: Hemodynamic recovery after cerebrovascular bypass brings about a better outcome in ischemic stroke. The result of surgery improves with proper selection of patients with hemodynamic impairment (in Stage 2). With various modalities such as intraoperative Doppler, DIVA (Dual-image Video Angiography) and improved surgical techniques may aid in the reduction of complications and improve clinical outcome.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded32    
    Comments [Add]    

Recommend this journal