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Cerebrovascular insufficiency 

Cerebrovascular insufficiency is a condition involving multiple occlusions or stenoses (narrowings) of the arteries supplying the brain usually resulting from atherosclerosis. This impairment of blood supply to the brain causes recurrent strokes which can cause neurological deficits.

Treatment - surgical recanalization procedures

In most cases, the therapy of stenotic or occluded vessels consists of medical treatment with anti-platelet medicine or endovascular angioplasty and/or stenting. During the endovascular procedure, a catheter is threaded from the groin to the site of the blockage, where a balloon tip is inflated to open the artery. A stent may be placed in the artery to expand it and hold it open.

In some cases, these less-invasive procedures do not suffice to restore the blood supply of the brain and a surgical recanalization procedure is necessary. In this microsurgical procedure, a so-called extra-intracranial bypass, a vessel graft is harvested from somewhere else in the body. The graft is connected above and below the blocked artery so that blood flow is rerouted through the graft. An intraoperative fluorescence angiogram allows instant control of the restored blood flow.

Regular postoperative follow-ups include special imaging and angiographic techniques to assess the patency of the graft.