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Chapter 6 - Combined Transcranial Approach for Tumor Resection and Anterior Circulation Vascular Bypass

from Section II - Open Combined Approaches

Published online by Cambridge University Press:  05 October 2021

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Summary

Skull base tumors are often intimately involved with critical vascular structures, which can be a barrier to maximal resection. In these cases, cerebral revascularization, including vascular bypass, can be an important adjunct technique. The feasibility of bypass depends on patient history, the anticipated tumor pathology, and characteristics of the cerebral vasculature. These procedures require considerable experience and expertise, and their indications must be well considered before performing them. A number of imaging and interventional studies can help establish the utility and feasibility of bypass preoperatively. Emerging technologies will help to refine the indications and streamline the performance of these challenging procedures. Here, we discuss the historical basis of bypass in skull base tumor surgery, indications in the modern era, the microanatomy of common bypasses, patient selection, and endovascular options for revascularization.

Type
Chapter
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Integrated Management of Complex Intracranial Lesions
Open, Endoscopic, and Keyhole Techniques
, pp. 51 - 66
Publisher: Cambridge University Press
Print publication year: 2021

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References

Sekhar, LN, Natarajan, SK, Ellenbogen, RG, Ghodke, B. Cerebral revascularization for ischemia, aneurysms, and cranial base tumors. Neurosurgery. 2008;62(6 Suppl 3):1373–408; discussion 408–10.CrossRefGoogle ScholarPubMed
Walker, M, Acharya, J, Bird, CR, Partovi, S. Evaluation of EC-IC bypass grafts using CT angiography. Barrow Quarterly. 2001;17(3).Google Scholar
Mohit, AA, Sekhar, LN, Natarajan, SK, Britz, GW, Ghodke, B. High-flow bypass grafts in the management of complex intracranial aneurysms. Neurosurgery. 2007;60(2 Suppl 1):ONS105–22; discussion ONS22–3.Google Scholar
Wessels, L, Hecht, N, Vajkoczy, P. Bypass in neurosurgery-indications and techniques. Neurosurg Rev. 2019;42(2):389–93.CrossRefGoogle ScholarPubMed
Tayebi Meybodi, A, Huang, W, Benet, A, Kola, O, Lawton, MT. Bypass surgery for complex middle cerebral artery aneurysms: an algorithmic approach to revascularization. J Neurosurg. 2017;127(3):463–79.Google Scholar
Ramanathan, D, Temkin, N, Kim, LJ, Ghodke, B, Sekhar, LN. Cerebral bypasses for complex aneurysms and tumors: long-term results and graft management strategies. Neurosurgery. 2012;70(6):1442–57; discussion 57.Google Scholar
Group EIBS. Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial.New England Journal of Medicine. 1985;313(19):1191–200.Google Scholar
Grubb, RL Jr., Powers, WJ, Clarke, WR, Videen, TO, Adams, HP Jr., Derdeyn, CP, et al. Surgical results of the Carotid Occlusion Surgery Study. J Neurosurg. 2013;118(1):2533.Google Scholar
Miyamoto, S, Yoshimoto, T, Hashimoto, N, Okada, Y, Tsuji, I, Tominaga, T, et al. Effects of extracranial-intracranial bypass for patients with hemorrhagic moyamoya disease: results of the Japan Adult Moyamoya Trial. Stroke. 2014;45(5):1415–21.Google Scholar
Esposito, G, Amin-Hanjani, S, Regli, L. Role of and Indications for Bypass Surgery After Carotid Occlusion Surgery Study (COSS)? Stroke. 2016;47(1):282–90.Google Scholar
Ginat, DT, Smith, ER, Robertson, RL, Scott, RM, Schaefer, PW. Imaging after direct and indirect extracranial-intracranial bypass surgery. AJR Am J Roentgenol. 2013;201(1):W124–32.Google Scholar
Langner, S, Fleck, S, Seipel, R, Schroeder, HW, Hosten, N, Perfusion, Kirsch M. CT scanning and CT angiography in the evaluation of extracranial-intracranial bypass grafts. J Neurosurg. 2011;114(4):978–83.CrossRefGoogle ScholarPubMed
Teng, MM, Jen, SL, Chiu, FY, Kao, YH, Lin, CJ, Chang, FC. Change in brain perfusion after extracranial-intracranial bypass surgery detected using the mean transit time of computed tomography perfusion. J Chin Med Assoc. 2012;75(12):649–53.Google Scholar
Low, SW, Teo, K, Lwin, S, Yeo, LL, Paliwal, PR, Ahmad, A, et al. Improvement in cerebral hemodynamic parameters and outcomes after superficial temporal artery-middle cerebral artery bypass in patients with severe stenoocclusive disease of the intracranial internal carotid or middle cerebral arteries. J Neurosurg. 2015;123(3):662–9.CrossRefGoogle ScholarPubMed
Serrone, JC, Jimenez, L, Hanseman, DJ, Carroll, CP, Grossman, AW, Wang, L, et al. Changes in computed tomography perfusion parameters after superficial temporal artery to middle cerebral artery bypass: an analysis of 29 cases. Journal of Neurological Surgery Part B, Skull Base. 2014;75(6):371–7.Google Scholar
Kwon, WK, Kwon, TH, Park, DH, Kim, JH, Ha, SK. Efficacy of superficial temporal artery-middle cerebral artery bypass in cerebrovascular steno-occlusive diseases: Hemodynamics assessed by perfusion computed tomography. Asian Journal of Neurosurgery. 2017;12(3):519–24.Google Scholar
Vos, PC, Riordan, AJ, Smit, EJ, de Jong, HW, van der Zwan, A, Velthuis, BK, et al. Computed tomography perfusion evaluation after extracranial-intracranial bypass surgery. Clinical Neurology and Neurosurgery. 2015;136:139–46.CrossRefGoogle ScholarPubMed
Kotapka, MJ, Kalia, KK, Martinez, AJ, Sekhar, LN. Infiltration of the carotid artery by cavernous sinus meningioma. J Neurosurg. 1994;81(2):252–5.CrossRefGoogle ScholarPubMed
Sekhar, LN, Bucur, SD, Bank, WO, Wright, DC. Venous and arterial bypass grafts for difficult tumors, aneurysms, and occlusive vascular lesions: evolution of surgical treatment and improved graft results. Neurosurgery. 1999;44(6):1207–23; discussion 23–4.Google Scholar
Natarajan, SK, Sekhar, LN, Schessel, D, Morita, A. Petroclival meningiomas: multimodality treatment and outcomes at long-term follow-up. Neurosurgery. 2007;60(6):965–79; discussion 79–81.CrossRefGoogle ScholarPubMed
Sekhar, LN, Kalavakonda, C. Cerebral revascularization for aneurysms and tumors. Neurosurgery. 2002;50(2):321–31.Google Scholar
Sekhar, LN, Tzortzidis, FN, Bejjani, GK, Schessel, DA. Saphenous vein graft bypass of the sigmoid sinus and jugular bulb during the removal of glomus jugulare tumors. Report of two cases. J Neurosurg. 1997;86(6):1036–41.Google Scholar
Tzortzidis, F, Elahi, F, Wright, D, Natarajan, SK, Sekhar, LN. Patient outcome at long-term follow-up after aggressive microsurgical resection of cranial base chordomas. Neurosurgery. 2006;59(2):230–7; discussion 207.Google Scholar
Tzortzidis, F, Elahi, F, Wright, DC, Temkin, N, Natarajan, SK, Sekhar, LN. Patient outcome at long-term follow-up after aggressive microsurgical resection of cranial base chondrosarcomas. Neurosurgery. 2006;58(6):1090–8; discussion 1098.Google Scholar
Kalavakonda, C, Sekhar, LN. Cerebral revascularization in cranial base tumors. Neurosurgery clinics of North America. 2001;12(3):557–74, viii–ix.Google Scholar
Akbarian-Tefaghi, H, Kalakoti, P, Sun, H, Sharma, K, Thakur, JD, Patra, DP, et al. Impact of hospital caseload and elective admission on outcomes after extracranial-intracranial bypass surgery. World Neurosurgery. 2017;108:716–28.CrossRefGoogle ScholarPubMed
Yang, T, Tariq, F, Chabot, J, Madhok, R, Sekhar, LN. Cerebral revascularization for difficult skull base tumors: a contemporary series of 18 patients. World Neurosurgery. 2014;82(5):660–71.Google Scholar
McCracken, DJ, Higginbotham, RA, Boulter, JH, Liu, Y, Wells, JA, Halani, SH, et al. Degree of vascular encasement in sphenoid wing meningiomas predicts postoperative ischemic complications. Neurosurgery. 2017;80(6):957–66.Google Scholar
Wolfe, SQ, Tummala, RP, Morcos, JJ. Cerebral revascularization in skull base tumors. Skull Base. 2005;15(1):7182.Google Scholar
Wolfswinkel, EM, Landau, MJ, Ravina, K, Kokot, NC, Russin, JJ, Carey, JN. EC-IC bypass for cerebral revascularization following skull base tumor resection: current practices and innovations. J Surg Oncol. 2018;118(5):815–25.Google Scholar
Di Maio, S, Ramanathan, D, Garcia-Lopez, R, Rocha, MH, Guerrero, FP, Ferreira, M Jr., et al. Evolution and future of skull base surgery: the paradigm of skull base meningiomas. World Neurosurgery. 2012;78(3–4):260–75.Google Scholar
Farsad, K, Hayek, RA, Mamourian, AC, Friedman, JA. Computerized tomographic angiography for preoperative assessment of the superficial temporal artery for external carotid artery to internal carotid artery bypass: Case illustration. Cases J. 2008;1(1):119.CrossRefGoogle ScholarPubMed
Kramer, M, Vairaktaris, E, Nkenke, E, Schlegel, KA, Neukam, FW, Lell, M. Vascular mapping of head and neck: computed tomography angiography versus digital subtraction angiography. Journal of Oral and Maxillofacial Surgery. 2008;66(2):302–7.CrossRefGoogle ScholarPubMed
Bi, WL, Brown, PA, Abolfotoh, M, Al-Mefty, O, Mukundan, S Jr., Dunn, IF. Utility of dynamic computed tomography angiography in the preoperative evaluation of skull base tumors. J Neurosurg. 2015;123(1):18.Google Scholar
Matsumoto, M, Kodama, N, Endo, Y, Sakuma, J, Suzuki, K, Sasaki, T, et al. Dynamic 3D-CT Angiography. 2007;28(2):299304.Google Scholar
Gupta, S, Bi, WL, Mukundan, S, Al-Mefty, O, Dunn, IF. Clinical applications of dynamic CT angiography for intracranial lesions. Acta Neurochirurgica. 2018;160(4):675–80.Google Scholar
Ramina, R, de Aguiar, PHP, Tatagiba, M. Samii’s Essentials in Neurosurgery. Springer Berlin Heidelberg; 2014.CrossRefGoogle Scholar
Sia, SF, Morgan, MK. High flow extracranial-to-intracranial brain bypass surgery. J Clin Neurosci. 2013;20(1):15.Google Scholar
Leech, PJ, Miller, JD, Fitch, W, Barker, J. Cerebral blood flow, internal carotid artery pressure, and the EEG as a guide to the safety of carotid ligation. J Neurol Neurosurg Psychiatry. 1974;37(7):854–62.Google Scholar
Sorteberg, A, Bakke, SJ, Boysen, M, Sorteberg, W. Angiographic balloon test occlusion and therapeutic sacrifice of major arteries to the brain. Neurosurgery. 2008;63(4):651–60; discussion 60–1.Google Scholar
Barr, JD, Lemley, TJ, McCann, RM. Carotid artery balloon test occlusion: combined clinical evaluation and xenon-enhanced computed tomographic cerebral blood flow evaluation without patient transfer or balloon reinflation: technical note. Neurosurgery. 1998;43(3):634–7; discussion 7–8.Google Scholar
Sorteberg, A. Balloon occlusion tests and therapeutic vessel occlusions revisited: when, when not, and how. AJNR American Journal of Neuroradiology. 2014;35(5):862–5.Google Scholar
Sorteberg, A, Sorteberg, W, Bakke, SJ, Lindegaard, KF, Boysen, M, Nornes, H. Varying impact of common carotid artery digital compression and internal carotid artery balloon test occlusion on cerebral hemodynamics. Head & Neck. 1998;20(8):687–94.Google Scholar
Origitano, TC, al-Mefty, O, Leonetti, JP, DeMonte, F, Reichman, OH. Vascular considerations and complications in cranial base surgery. Neurosurgery. 1994;35(3):351–62; discussion 62–3.Google Scholar
Lawton, MT, Hamilton, MG, Morcos, JJ, Spetzler, RF. Revascularization and aneurysm surgery: current techniques, indications, and outcome. Neurosurgery. 1996;38(1):8392; discussion 94.Google Scholar
Lougheed, WM, Marshall, BM, Hunter, M, Michel, ER, Sandwith-Smyth, H. Common carotid to intracranial internal carotid bypass venous graft. Technical note. J Neurosurg. 1971;34(1):114–18.Google Scholar
Kawashima, M, Rhoton, AL Jr., Tanriover, N, Ulm, AJ, Yasuda, A, Fujii, K. Microsurgical anatomy of cerebral revascularization. Part I: Anterior circulation. J Neurosurg. 2005;102(1):116–31.Google ScholarPubMed
Ausman, JI, Nicoloff, DM, Chou, SN. Posterior fossa revascularization: anastomosis of vertebral artery to PICA with interposed radial artery graft. Surgical Neurology. 1978;9(5):281–6.Google Scholar
Evans, JJ, Sekhar, LN, Rak, R, Stimac, D. Bypass grafting and revascularization in the management of posterior circulation aneurysms. Neurosurgery. 2004;55(5):1036–49.Google Scholar
Strickland, BA, Rennert, RC, Bakhsheshian, J, Bulic, S, Correa, AJ, Amar, A, et al. Botulinum toxin to improve vessel graft patency in cerebral revascularization surgery: report of 3 cases. J Neurosurg. 2018;130:17.Google Scholar
Sia, SF, Davidson, AS, Assaad, NN, Stoodley, M, Morgan, MK. Comparative patency between intracranial arterial pedicle and vein bypass surgery. Neurosurgery. 2011;69(2):308–14.Google Scholar
Regli, L, Piepgras, DG, Hansen, KK. Late patency of long saphenous vein bypass grafts to the anterior and posterior cerebral circulation. J Neurosurg. 1995;83(5):806–11.Google Scholar
Bulsara, KR, Patel, T, Fukushima, T. Cerebral bypass surgery for skull base lesions: technical notes incorporating lessons learned over two decades. Neurosurgical Focus. 2008;24(2):E11.Google Scholar
Nwasokwa, ON. Coronary artery bypass graft disease. Annals of Internal Medicine. 1995;123(7):528–45.Google Scholar
Shuhaiber, JH, Evans, AN, Massad, MG, Geha, AS. Mechanisms and future directions for prevention of vein graft failure in coronary bypass surgery. European Journal of Cardio-Thoracic Surgery. 2002;22(3):387–96.Google Scholar
Streefkerk, HJ, Bremmer, JP, Tulleken, CA. The ELANA technique: high flow revascularization of the brain. Acta Neurochirurgica Supplement. 2005;94:143–8.Google Scholar
Streefkerk, HJ, Bremmer, JP, van Weelden, M, van Dijk, RR, de Winter, E, Beck, RJ, et al. The excimer laser-assisted nonocclusive anastomosis practice model: development and application of a tool for practicing microvascular anastomosis techniques. Neurosurgery. 2006;58(1 Suppl):ONS148–56; discussion ONS56.Google Scholar
Streefkerk, HJ, Wolfs, JF, Sorteberg, W, Sorteberg, AG, Tulleken, CA. The ELANA technique: constructing a high flow bypass using a non-occlusive anastomosis on the ICA and a conventional anastomosis on the SCA in the treatment of a fusiform giant basilar trunk aneurysm. Acta Neurochirurgica. 2004;146(9):1009–19; discussion 1019.Google Scholar
Kalani, MY, Kalb, S, Martirosyan, NL, Lettieri, SC, Spetzler, RF, Porter, RW, et al. Cerebral revascularization and carotid artery resection at the skull base for treatment of advanced head and neck malignancies. J Neurosurg. 2013;118(3):637–42.Google Scholar
Terasaka, S, Asaoka, K, Kobayashi, H, Yamaguchi, S, Sawamura, Y. Natural history and surgical results of petroclival meningiomas. No Shinkei Geka. Neurological Surgery. 2010;38(9):817–24.Google Scholar
Van Havenbergh, T, Carvalho, G, Tatagiba, M, Plets, C, Samii, M. Natural history of petroclival meningiomas. Neurosurgery. 2003;52(1):5562; discussion 64.Google Scholar
Pearson, BE, Markert, JM, Fisher, WS, Guthrie, BL, Fiveash, JB, Palmer, CA, et al. Hitting a moving target: evolution of a treatment paradigm for atypical meningiomas amid changing diagnostic criteria. Neurosurgical Focus. 2008;24(5):E3.Google Scholar
Kshettry, VR, Ostrom, QT, Kruchko, C, Al-Mefty, O, Barnett, GH, Barnholtz-Sloan, JS. Descriptive epidemiology of World Health Organization grades II and III intracranial meningiomas in the United States. Neuro-oncology. 2015;17(8):1166–73.Google Scholar
McGovern, SL, Aldape, KD, Munsell, MF, Mahajan, A, DeMonte, F, Woo, SY. A comparison of World Health Organization tumor grades at recurrence in patients with non-skull base and skull base meningiomas. J Neurosurg. 2010;112(5):925–33.CrossRefGoogle ScholarPubMed
Litre, CF, Colin, P, Noudel, R, Peruzzi, P, Bazin, A, Sherpereel, B, et al. Fractionated stereotactic radiotherapy treatment of cavernous sinus meningiomas: a study of 100 cases. International Journal of Radiation Oncology, Biology, Physics. 2009;74(4):1012–17.CrossRefGoogle ScholarPubMed
Skeie, BS, Enger, PO, Skeie, GO, Thorsen, F, Pedersen, PH. Gamma knife surgery of meningiomas involving the cavernous sinus: long-term follow-up of 100 patients. Neurosurgery. 2010;66(4):661–8; discussion 8–9.Google Scholar
Aghi, MK, Carter, BS, Cosgrove, GR, Ojemann, RG, Amin-Hanjani, S, Martuza, RL, et al. Long-term recurrence rates of atypical meningiomas after gross total resection with or without postoperative adjuvant radiation. Neurosurgery. 2009;64(1):5660.Google Scholar
Durand, A, Labrousse, F, Jouvet, A, Bauchet, L, Kalamarides, M, Menei, P, et al. WHO grade II and III meningiomas: a study of prognostic factors. Journal of Neuro-oncology. 2009;95(3):367–75.Google Scholar
Wanibuchi, M, Akiyama, Y, Mikami, T, Iihoshi, S, Miyata, K, Horita, Y, et al. Radical removal of recurrent malignant meningeal tumors of the cavernous sinus in combination with high-flow bypass. World Neurosurgery. 2015;83(4):424–30.Google Scholar
Di Maio, S, Rostomily, R, Sekhar, LN. Current surgical outcomes for cranial base chordomas: cohort study of 95 patients. Neurosurgery. 2011;70(6):1355–60.Google Scholar
Tzortzidis, F, Elahi, F, Wright, DC, Temkin, N, Natarajan, SK, Sekhar, LN. Patient outcome at long-term follow-up after aggressive microsurgical resection of cranial base chondrosarcomas. Neurosurgery. 2006;58(6):1090–8.Google Scholar
Sekhar, LN, Pranatartiharan, R, Chanda, A, Wright, DC. Chordomas and chondrosarcomas of the skull base: results and complications of surgical management. Neurosurgical Focus. 2001;10(3):14.Google Scholar
Gil, Z, Patel, SG, Singh, B, Cantu, G, Fliss, DM, Kowalski, LP, et al. Analysis of prognostic factors in 146 patients with anterior skull base sarcoma: an international collaborative study. Cancer. 2007;110(5):1033–41.Google Scholar
Ganly, I, Patel, SG, Singh, B, Kraus, DH, Bridger, PG, Cantu, G, et al. Complications of craniofacial resection for malignant tumors of the skull base: report of an International Collaborative Study. Head & Neck. 2005;27(6):445–51.Google Scholar
Feiz-Erfan, I, Han, PP, Spetzler, RF, Lanzino, G, Ferreira, MA, Gonzalez, LF, et al. Salvage of advanced squamous cell carcinomas of the head and neck: internal carotid artery sacrifice and extracranial-intracranial revascularization. Neurosurgical Focus. 2003;14(3):e6.CrossRefGoogle ScholarPubMed
Chazono, H, Okamoto, Y, Matsuzaki, Z, Ogino, J, Endo, S, Matsuoka, T, et al. Extracranial-intracranial bypass for reconstruction of internal carotid artery in the management of head and neck cancer. Annals of Vascular Surgery. 2003;17(3):260–5.Google Scholar
Gormley, WB, Sekhar, LN, Wright, DC, Olding, M, Janecka, IP, Snyderman, CH, et al. Management and long-term outcome of adenoid cystic carcinoma with intracranial extension: a neurosurgical perspective. Neurosurgery. 1996;38(6):1105–12; discussion 12–13.Google Scholar
Lawton, MT, Lang, MJ. The future of open vascular neurosurgery: perspectives on cavernous malformations, AVMs, and bypasses for complex aneurysms. J Neurosurg. 2019;130(5):1409–25.Google Scholar
Abdulrauf, SI. Awake craniotomies for aneurysms, arteriovenous malformations, skull base tumors, high flow bypass, and brain stem lesions. Journal of Craniovertebral Junction & Spine. 2015;6(1):89.Google Scholar
Chen, C, Yang, Y, Ling, C, He, H, Luo, L, Wang, H. Percutaneous transluminal angioplasty for radial artery graft stenosis after high-flow superficial temporal artery trunk to middle cerebral artery interposition bypass. British Journal of Neurosurgery. 2019:14.CrossRefGoogle Scholar
Aydin, E, Gok, M, Esenkaya, A, Cinar, C, Oran, I. Endovascular management of iatrogenic vascular injury in the craniocervical region. Turk Neurosurg. 2018;28(1):72–8.Google Scholar
Dlamini, N, Shah-Basak, P, Leung, J, Kirkham, F, Shroff, M, Kassner, A, et al. Breath-hold blood oxygen level–dependent MRI: a tool for the assessment of cerebrovascular reserve in children with Moyamoya disease. AJNR Am J Neuroradiol. 2018;39(9):1717–23.Google Scholar
Ge, X, Zhao, H, Zhou, Z, Li, X, Sun, B, Wu, H, et al. Association of fractional flow on 3D-TOF-MRA with cerebral perfusion in patients with MCA stenosis. AJNR Am J Neuroradiol. 2019;40(7):1124–31.Google Scholar

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