A NEW-TYPE OF EXTRACRANIAL INTRACRANIAL BYPASS FOR RECURRENT HEMODYNAMIC TRANSIENT ISCHEMIC ATTACKS/

Since the completion of the international extracranial/intracranial (E C/IC) bypass study in 1985, no treatment of proven value has become av ailable for patients with symptomatic carotid artery occlusion other t han treatment with antithrombotic medication, However, in this trial t he causal factors of cerebral ischaemia were not part of the inclusion criteria and also patients with single episodes only were included, W e report successful Excimer laser-assisted high flow. EC/IC bypass sur gery in a patient with frequent transient ischaemic attacks associated with a low flow state of the cerebral circulation, In the 1.5 years a fter the operation the patient has never again experienced any symptom s of cerebral ischaemia, In addition there was improvement in cerebral blood flow, measured by magnetic resonance spectroscopy and hexamethy lpropyleneamine oxime single photon emission computed tomography, Cert ain patients with occlusion of the internal carotid artery may benefit from EC/IC bypass surgery, in particular the Excimer laser-assisted h igh-flow bypass, that is? if recurrent (transient) ischaemic attacks a re associated with compromised cerebral perfusion.