Two-stage carotid saphenous vein interposition graft and superficial temporal artery bypass for acute carotid occlusion

The safety and efficacy of bypass surgery to achieve cerebral revascularization for cerebral hypoperfusion are controversial. However, bypass surgery still plays an important role for a select group of patients.The indication to perform a high-flow or low-flow bypass in cases of acute symptomatic artery occlusion is not defined. Neurologic symptoms in acute symptomatic occlusion are usually blood pressure dependent, and acute blood flow restoration may be considered. This report reviews the case of a patient with an acute carotid occlusion in which a two-stage bypass technique was used to achieve revascularization and discusses the issues influencing the decision-making.