Experimental augmentation of regional cerebral blood flow by microvascular anastomosis

Abstract

✓ Intracranial surgical procedures for cerebrovascular occlusive disease have become feasible with the development of microvascular surgical techniques. This study assesses the ability of microanastomoses of the superficial temporal and cortical arteries to augment cerebral blood flow after clip occlusion of the middle cerebral artery in the dog. The ischemic insult was marked by a variable degree of regional flow depression but consistent disruption of the blood-brain barrier. Significant augmentation of cerebral blood flow was noted after anastomosis to cortical arteries in proximity to the occlusion and was associated with a characteristic widening of the pressure flow hysteresis loop obtained on autoregulatory testing. Survival was noted only in those animals demonstrating a measurable flow increase, although the latter could not be correlated with specific degrees of neurological improvement.