Vascular

Cerebral revascularization (EC-IC bypass)

Also called: EC-IC bypass, STA-MCA bypass, parent artery occlusion

Cerebral bypass routes blood from an extracranial donor artery (or a graft) to an intracranial artery, so that a complex aneurysm and its parent vessel can be clipped, trapped or occluded safely.

An extracranial-to-intracranial (EC-IC) bypass connects a scalp or neck artery to a brain artery. A low-flow bypass typically uses the superficial temporal artery joined to a branch of the middle cerebral artery (STA-MCA). A high-flow bypass uses an interposition graft, such as the radial artery or saphenous vein, from the external carotid circulation.

In aneurysm surgery, bypass protects the territory downstream of an aneurysm so that the aneurysm can be excluded by clipping, trapping or parent artery occlusion (PAO), where the artery feeding the aneurysm is deliberately closed.

Choosing between clip reconstruction, bypass with clipping and bypass with parent artery occlusion depends on aneurysm site, branch involvement and the patient's collateral circulation.

Tools that use this

Giant Aneurysm Strategy StudioPredicted good functional outcome (mRS 0-3) for clip only, bypass and clip, or bypass and parent artery occlusion in giant intracranial aneurysms.

Related terms

Educational reference. Not medical advice and not for clinical decision-making.