RT Journal Article
SR Electronic
T1 Republished: Thrombectomy for late occlusion of high flow extracranial–intracranial saphenous vein bypass graft after 27 years of patency
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP e27
OP e27
DO 10.1136/neurintsurg-2017-013670.rep
VO 10
IS 11
A1 Michael A Silva
A1 Rodolfo E Alcedo Guardia
A1 Mohammad Ali Aziz-Sultan
A1 Nirav J Patel
YR 2018
UL http://jnis.bmj.com/content/10/11/e27.abstract
AB High flow extracranial–intracranial (EC-IC) bypass with a saphenous vein graft (SVG) has been used for more than 40 years in patients with giant aneurysms of the posterior circulation refractory to medical management, and has demonstrated high long term patency rates. We report the case of a patient treated with external carotid artery (ECA)–posterior cerebral artery SVG bypass in 1989 who presented 27 years later with paresthesias and confusion, and was found to have partial occlusion of her SVG bypass graft and a basilar occlusion. She was treated with mechanical thrombectomy of the basilar occlusion via the partially thrombosed graft, the first report of such a procedure through a high flow posterior circulation EC-IC SVG, resulting in improvement of the patient’s neurologic examination. At 27 years, this is the longest reported delay in thrombosis of a high flow SVG bypass graft, highlighting the long term patency of these grafts and the feasibility of thrombectomy through occluded bypass grafts.