JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
Can surgical embolectomy or bypass surgery be the first treatment option in ischemic cerebrovascular pathologies?
Abstract
Aims: Well-established treatment methods have been utilized for intracerebral vascular occlusion, including medical thrombolytic treatments, endovascular interventions, and surgical procedures. We aimed with this study to show rapid and first-line surgical treatment is good option for recanalization.
Methods: This study focused on surgical recanalization techniques, illustrating them through seven patients. In emergency scenarios at our hospital, late term thromboembolectomy was performed on three patients who had experienced thromboembolic events. The other two patients were treated not in emergency conditions, but with by-pass surgery in the following week. Last two patients were in the group of patients who had reperfusion with recanalization surgery due to chronic ischemic intracerebral processes with clinical symptoms. This study was done retrospectively.
Results: One of the patient underwent emergency surgery for total infarction of the internal carotid artery (ICA), which remained unresponsive to other therapeutic approaches. Similarly, the second patient, who had undergone heart transplantation, required surgery due to unyielding small atheroma plaques originating from the main arteries after failed thrombolytic treatments. Similarly, after cardiac surgery, the patient who had a complete blockage at the bifurcation point of the right anal artery with an atheroma plaque was taken into emergency surgery. Successful recanalization procedures were achieved in three cases. Among the other patients who underwent semi-emergency surgery, one patient with internal carotid artery insufficiency after a traumatic process, another patient with left hemisphere vascular insufficiency after vascular disease, and another two patients who had vascular insufficiency due to occlusion of the main vascular structure by an aneurysm thrombus were operated on.
Conclusion: Our findings suggest that surgical intervention could be considered as the primary treatment option in selected cases for managing acute stroke or vascular insufficiency. In selected patients, rapid and first-line surgical treatment is satisfactory. This approach aligns with the need for more comprehensive investigations to determine the optimal approach in different scenarios of intracerebral vascular occlusion.

Keywords : Intracranial bypass, neurosurgery, recanalization surgery, stroke

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Article available in :
Volume 4, Issue 5, 2023
Page : 585-590
https://doi.org/10.47582/jompac.1352325
Article Information
Received : 30 Ağu 2023
Accepted : 15 Eki 2023
Published : 27 Eki 2023
Corresponding Author :

Hakan Çakın: Department of Neurosurgery, Faculty of Medicine, Akdeniz University, Antalya, Turkey

[email protected]
Citation : Çakın H, Gediz T. Can surgical embolectomy or bypass surgery be the first treatment option in ischemic cerebrovascular pathologies?. J Med Palliat Care. 2023;4(5):585-590.

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