Skull Base 2005; 15(1): 71-82
DOI: 10.1055/s-2005-868164
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Cerebral Revascularization in Skull Base Tumors

Stacey Quintero Wolfe1 , Ramachandra P. Tummala1 , Jacques J. Morcos1
  • 1Department of Neurosurgery, University of Miami, Miami, Florida
Further Information

Publication History

Publication Date:
14 April 2005 (online)

ABSTRACT

Skull base tumors involving the carotid artery pose a difficult surgical challenge. The potential for bypass grafting for cerebral revascularization carries inherent risks but may aid in tumor resection and control in those who warrant carotid sacrifice but have inappropriate natural cerebrovascular reserve. We include a review of the literature discussing the indications for carotid resection as part of skull base tumor surgery, indications for cerebral revascularization, balloon test occlusion, graft types and operative technique, complications, and results.

REFERENCES

  • 1 Conley J. Free autogenous vein graft to the internal and common carotid arteries in the treatment of tumors of the neck.  Ann Surg. 1953;  137 205-214
  • 2 Lougheed W, Marshall B, Hunter M et al.. Common carotid to internal carotid bypass venous graft. Technical note.  J Neurosurg. 1971;  34 114-118
  • 3 Fisch U P, Olding D J, Senning A. Surgical therapy of internal carotid artery lesions of the skull base and temporal bone.  Otolaryngol Head Neck Surg. 1980;  88 548-554
  • 4 Glassock M, Smith P, Bond A, Whitaker S, Bartels L. Management of aneurysms of the petrous portion of the internal carotid artery by resection and primary anastomosis.  Laryngoscope. 1983;  93 1445-1453
  • 5 Sekhar L, Sen C, Jho H. Saphenous vein graft bypass of the cavernous internal carotid artery.  J Neurosurg. 1990;  72 35-41
  • 6 Spetzler R, Fukushima T, Martin N et al.. Petrous carotid-to-intradural carotid saphenous vein graft for intracaverous giant aneurysm, tumor and occlusive cerebrovascular disease.  J Neurosurg. 1990;  73 496-501
  • 7 , [No authors listed]. Failure of external carotid-internal carotid arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. The EC/IC Bypass Study Group.  N Engl J Med. 1985;  313 1191-1200
  • 8 Muhm M, Grasl M, Burian M et al.. Carotid resection and reconstruction for locally advanced head and neck tumors.  Acta Otolaryngol. 2002;  122 561-564
  • 9 Kalavakonda C, Sekhar L N. Cerebral revascularization in cranial base tumors.  Neurosurg Clin N Am. 2001;  12 557-574; , viii-ix
  • 10 Lawton M, Hamilton M, Beals S, Joganic E, Spetzler R. Radical resection of anterior skull base tumors.  Clin Neurosurg. 1995;  42 43-70
  • 11 Wright G, Nicholson R, Schuller D, Smead W. Resection of the internal carotid artery and replacement with greater saphenous vein: a safe procedure for en bloc cancer resections with carotid involvement.  J Vasc Surg. 1996;  23 775-782
  • 12 Meredith S, Shores C, Carrasco V, Pillsbury H. Management of the carotid artery at the skull base.  Am J Otolaryngol. 2001;  22 336-342
  • 13 Sekhar L N, Bucur S D, Bank W O, Wright D C. Venous and arterial bypass grafts for difficult tumors, aneurysms and occlusive vascular lesions: evolution of surgical treatment and improved graft results.  Neurosurgery. 1999;  44 1207-1223 , discussion 1223-1224
  • 14 Tarr R, Jungreis C, Horton J et al.. Complications of preoperative balloon test occlusion of the internal carotid arteries: experience in 300 cases.  Skull Base Surgery. 1991;  1 240-244
  • 15 Origitano T C, al-Mefty O, Leonetti J P, DeMonte F, Reichman O H. Vascular considerations and complications in cranial base surgery.  Neurosurgery. 1994;  35 351-362 , discussion 362-363
  • 16 Drake C G, Peerless S J, Feguson G G. Hunteria proximal arterial occlusion for giant aneurysms of the carotid circulation.  J Neurosurg. 1994;  81 656-665
  • 17 Gonzalez C F, Moret J. Balloon occlusion of the carotid artery prior to surgery for neck tumors.  AJNR Am J Neuroradiol. 1190;  11 649-652
  • 18 Roski R, Spetzler R, Nulsen F. Late complications of carotid ligation in the treatment of intracranial aneurysms.  J Neurosurg. 1981;  54 583-587
  • 19 Lawton M T, Hamilton M G, Morcos J J, Spetzler R F. Revascularization and aneurysm surgery: current techniques, indications and outcome.  Neurosurgery. 1996;  38 83-92 , discussion 92-94
  • 20 Roberts B, Hardesty W, Holling H, Revich M, Toole J. Studies on extracranial cerebral blood flow.  Surgery. 1964;  56 826-833
  • 21 Sekhar L N, Kalavakonda C. Cerebral revascularization for aneurysms and tumors.  Neurosurgery. 2002;  50 321-331
  • 22 Sundt T, Piepgras D, Marsh R, Fode N. Saphenous vein bypass grafts for giant aneurysms and intracranial occlusive disease.  J Neurosurg. 1986;  65 439-450

Jacques J MorcosM.D. F.R.C.S. F.R.C.S. (Ed) 

Department of Neurosurgery, University of Miami

1095 NW 14th Terrace, Miami, FL 33136

Email: jmorcos@med.miami.edu