Extracranial to intracranial bypass for intracranial atherosclerosis
Summary
The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Extracranial to intracranial bypass for intracranial atherosclerosis in July 2004.
NICE has reviewed this guidance and is reassessing the procedure. New guidance will be published as a result. Until the new guidance is published the NHS should continue to follow the recommendations in the guidance below.
If you wish to be updated to any developments with this procedure, you can express an interest here
The Interventional Procedures Advisory Committee has considered this procedure and NICE has now issued a consultation document about its safety and efficacy. This has been issued for 4 weeks public consultation (until 5pm on 23rd March 2010).
If you wish to comment on the consultation document please use the link at the bottom of this page.
NICE is committed to promoting through its guidance race and disability equality and equality between men and women, and to eliminating all forms of discrimination. One of the ways we do this is by trying to involve as wide a range of people and interest groups as possible in the development of our guidance on interventional procedures. In particular, we aim to encourage people and organisations from groups in the population who might not normally comment on our guidance to do so. We also ask consultees to highlight any ways in which draft guidance fails to promote equality or tackle discrimination and how it might be improved.
If you wish to be alerted to developments regarding this procedure, including the release of NICE guidance, please express your interest at the top of the page.
Description
High flow interposition extracranial to intracranial bypass may be used to treat people with narrowing of blood vessels that supply the brain. Causes of narrowing include atherosclerosis, accidental trauma, moyamoya disease and intentional blockage of blood flow during surgery.
Narrowing of blood vessels to the brain may cause symptoms in itself, but the main objective of extracranial to intracranial bypass is to prevent complete blockage of the vessels, which may result in a stroke.
The procedure involves joining a blood vessel outside the skull (extracranial) to an artery inside the skull (intracranial). In high flow interposition extracranial to intracranial bypass, an artery or vein from another part of the body is used to connect the extracranial and intracranial arteries. The saphenous vein in the leg and the radial artery in the arm are most commonly used. Usually, the external carotid artery is connected to the middle cerebral artery. It has been argued that blood flow may be faster with this technique, making thrombosis less likely.
OPCS code:
Details
Surgical procedures
Society of British Neurological Surgeons
Contact details:
(for general enquiries or comments)
Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA
