ИСТИНА

Background. Extracranial-intracranial bypass remains an important treatment for flow augmentation or flow complementation in selected patients. However the indications and results of double-barrel bypasses are still unclear. The aim of the study was to assess the results and determine the most appropriate for double-barrel bypass group of patients. Methods: From 2009 to 2021 in Burdenko Neurosurgical Center double-barrel bypasses were performed in 71 patients. Among them there were 37 patients with chronic ICA occlusion, 28 patients with moyamoya disease, 3 patients with acute stroke and 3 patients with giant ICA aneurysms. Most of the patients had focal neurologic symptoms (86%) and ischemic foci (75%). In all patients double-barrel bypasses were performed between both frontal and temporal branches of STA and cortical branches of M4 segment of MCA. Results: In the early postoperative period there were good results in the most of patients (82%) with the immediate improvement of clinical symptoms in 17% of cases. The ischemic complications were seen in 8 patients (11%). Double-barrel bypasses were effective in 100% in patients with aneurysms, in 89% in moyamoya patients, in 75% in ICA occlusion group and in 67% in patients with acute stroke. Immediate clinical improvement more often was seen in patients with acute stroke (67%). Conclusions. Double-barrel STA-MCA bypass is feasible and advantageous method for restoring blood flow in selected groups of patients.