Microvascular bypass procedures for ischemic cerebrovascular disease.

Extracranial to intracranial (EC/IC) microvascular bypass grafts are being performed with increasing frequency for the treatment of cerebral ischemia due to "inaccessible" cerebrovascular disease including carotid artery occlusion and middle cerebral artery occlusion and stenosis. Patency rates, complications, and indications for superficial temporal to middle cerebral artery (STA-MCA) bypass are discussed. EC/IC bypasses can reduce or completely arrest TIAs in selected patients. The long term effect on stroke protection of a functioning STA-MCA bypass is now the subject of multinational controlled investigation.