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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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STA-MCA bypass for carotid occlusion can improve NIHSS

Meeting Abstract

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  • Oliver Bozinov - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Marian C. Neidert - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Jan-Karl Burkhardt - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Susanne Wegener - Klinik für Neurologie, Universitätsspital Zürich, Zürich, Schweiz

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.18.01

doi: 10.3205/14dgnc378, urn:nbn:de:0183-14dgnc3781

Published: May 13, 2014

© 2014 Bozinov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: The carotid occlusion surgery study (COSS) showed no benefit in stroke rate compared to medical treatment in a multicenter randomized study. Neurological comparison after bypass was not described. We analyzed our consecutive post COSS series of STA-MCA bypasses for carotid occlusion in a specialized single center operated by one surgeon.

Method: 10 consecutive patients (post COSS) were treated with a STA-MCA bypass for unilateral carotid occlusion with recurrent strokes and/or focal neurological symptoms. Patients were followed from 2011 with pre- and postoperative PET staging, duplex ultrasound as well as MRI imaging.

Results: The mean age was 66.7 years. The series included 8 male and 2 female patients. Peri- and postoperative stroke rate (until last follow-up) was 0 for all patients, a single TIA was reported in 2 patients each. PET criteria improved in 3 patients. Modified ranking scale improved from 2.0 to 1.5. NIHSS score improved from 4.2 to 1.9 (p=0.027). The analysis was performed using SPSS 21 (IBM, Armonk, USA).

Conclusions: Stroke rates can be reduced to a very low number in a specialized single center setting in well selected cases. STA-MCA bypass may have a positive influence on neurologic outcome as well.