EXTRACRANIAL-INTRACRANIAL HIGH-FLOW BYPASS USING THE RADIAL ARTERY BETWEEN THE VERTEBRAL AND MIDDLE CEREBRAL-ARTERIES - TECHNICAL NOTE

Carotid ligation and vascular reconstruction following radical neck di ssection were required in a patient with carotid artery rupture associ ated with an infected salivary fistula. An extracranial-intracranial h igh-flow bypass was performed using a radial arterial graft between th e V-3 segment of the vertebral artery and the M(2) segment of the midd le cerebral artery. Postoperative angiograms confirmed sufficient bloo d flow through the bypass graft into the ipsilateral internal carotid arterial system. No clinical signs of ischemia were observed postopera tively. This V-3-M(2) bypass procedure appears to be an effective mean s of controlling catastrophic bleeding from a ruptured carotid artery, thus allowing the wound to heal completely.