Young Neurosurgeons Discussions with the Experts; EC-IC Bypass Surgery 1980-2025

SUMMARY: Drs. Nussbaum and Ausman discuss with Dr. Rennert the years of experience with EC -IC Bypass surgery. For Ischemia the major issue was the 1985 EC-IC Bypass Study, a RCT that was scientifically corrupted and for which no valid data exists. Other studies either had major deficiencies such as too short a follow up, and too high a bypass mortality surgery. The high early mortality of these studies made it too much to overcome in the long-term followup of the patients with ischemia. With an expected 1% morbidity, recent studies show a signifiant value in EC-IC bypass surgery over medical therapy. The elimination of that mortality and morbidity is addressed by all surgeons. Dr. Rennert discusses three recent cases he has done in his center with different compromised anterior circulation patterns. One case with cerebral ischemia presenting with Memory loss and interrupted Speech was cured with successful EC-IC bypass surgery. Cerebral ischemia as a cause of memory loss was discussed. The importance of the understanding of the collateral circulation and the vascular supply to the cranial circulation was emphasized as was 4 -vessel angiography. The deficiency in CT Angiography in evaluation of CV circulation is discussed as was CBF flow studies. The discussion develops an Interesting interactive exchange of experience covering 55 years of literature and clinical experience with many tips for surgical successes. This experience is not available in journals or most meetings. This is Interesting learning experience not available in journals or most meetings but on SNI Digital®. Opportunities for other young neurosurgeons to participate in this new SNI Digital® series are proposed. (60 minutes Discussion). JIA .