Femoro-internal carotid artery bypass for cerebral ischemia in takayasu's arteritis.

In two patients with Takayasu's arteritis, severe cerebral ischemia was successfully treated by femoral to internal carotid artery bypass using a polytetrafluoroethylene (PTFE) graft through a subcutaneous tunnel. All of the arch branches were critically stenotic or occluded in both patients. The entire thoracic aorta was affected by the active inflammation process in one patient and there was marked calcification in the other patient. In these situations we hesitate to use the thoracic aorta as the donor site of bypass. Considering that Takayasu's arteritis affects the thoracic aorta and the proximal portions of its branches, the femoro-internal carotid artery bypass can be constructed without involving severely diseased vessels and can be expected to result in good cerebral revascularization.