Risk factors for XXXX and symptomatic watershed infarction in internal carotid artery aneurysm treated by extracranial-intracranial bypass using radial artery graft.

@entity1 @entity63 @entity2500 @entity16 @entity3538 @entity51 @entity439 @entity1188 @entity432
UNASSIGNED: OBJECT The revascularization technique, including bypass created using the external carotid artery (ECA), radial artery (RA), and M2 portion of @entity2500 ( @entity2500 ), has remained indispensable for treatment of complex @entity439 . To date, it remains unknown whether diameters of the RA, superficial temporal artery (STA), and C2 portion of the internal carotid artery (ICA) and intraoperative @entity2500 blood pressure have influences on the outcome and the symptomatic watershed @entity1188 (WI). The aim of the present study was to evaluate the factors for the symptomatic WI and @entity16 in @entity1 treated by ECA-RA-M2 bypass for complex ICA @entity439 with @entity432 . METHODS The authors measured the sizes of vessels (RA, C2, M2, and STA) and intraoperative @entity2500 blood pressure (initial, after ICA occlusion, and after releasing the RA graft bypass) in 37 @entity1 . Symptomatic WI was defined as presence of the following: postoperative new @entity51 , WI on postoperative diffusion-weighted imaging, and ipsilateral cerebral blood flow reduction on SPECT. Neurological worsening was defined as the increase in 1 or more modified Rankin Scale scores. First, the authors performed receiver operating characteristic curve analysis for continuous variables and the binary end point of the symptomatic WI. The clinical, radiological, and physiological characteristics of @entity1 with and without the symptomatic WI were compared using the log-rank test. Then, the authors compared the variables between @entity1 with and without @entity16 at discharge and at the 12-month follow-up examination or last hospital visit. RESULTS Symptomatic WI was observed in 2 (5.4%) @entity1 . The mean @entity2500 pressure after releasing the RA graft (< 55 mm Hg; p = 0.017), mean ( @entity2500 pressure after releasing the RA graft)/(initial @entity2500 pressure) (< 0.70 mm Hg; p = 0.032), and mean cross-sectional area ratio ([RA/C2 diameter](2) < 0.40 mm [p < 0.0001] and [STA/C2 diameter](2) < 0.044 mm [p < 0.0001]) were related to the symptomatic WI. All preoperatively independent @entity1 remained independent (modified Rankin Scale score < 3). After adjusting for age and sex, left operative side (p = 0.0090 and 0.038) and perforating @entity63 (p = 0.0050 and 0.022) were related to @entity16 at discharge (11 [29%] @entity1 ) and at the 12-month follow-up or last hospital visit (8 [22%] @entity1 ). CONCLUSIONS Results of the present study showed that the vessel diameter and intraoperative @entity2500 pressure had impacts on the symptomatic WI and that operative side and perforating @entity63 were related to @entity16 in @entity1 with @entity3538 treated by ECA-RA-M2 bypass.
