Page 35 - Head and neck surgery

Routine resection of the internal carotid artery may lead to cerebral infarction of the middle

cerebral artery territory, leading to severe neurological deficit.

To prevent this complication, cerebral perfusion is preserved, before the resection of the artery,

by creating an ipsilateral extra-anatomical vascular bypass. This is called extracranial – intracranial

bypass (EC – IC bypass).

EC – IC bypass is performed using autologous vein / arterial interposition graft, which is

anastomosed to the carotid artery in the neck (extracranial part) and the middle cerebral artery

(intracranial part).

The bypass graft usually travels through a subcutaneous tunnel in the pre-auricular region.