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XXI Congreso Nacional de la Sociedad Española de Neurocirugía
Barcelona, 17-19 May 2017
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The role of revascularization in contemporary neurovascular services

R.J. Nelson

Consultant Neurosurgeon. Institute of Clinical Neurosciences, Bristol, United Kingdom. President Joint Neurosciences Council. Past President, Society of British Neurological Surgeons. Chair, Neurosurgcial National Audit Programme.

Over the last 30 years the role of cerebral re-vascularisation surgery has been drawn into question by two randomised controlled trials (RCTs - EC-IC Bypass Study and COSS); major advances in endovascular interventional treatment; improvements in the medical management of cerebrovascular disease and the introduction of sophisticated radiotherapy treatments for skull-base tumours.

Despite these developments there remains an important place for both intra and extracranial revascularisation that includes the management of: complex aneurysms; Moya Moya disease and syndromes in children and adults; non-atherosclerotic acquired cerebral ischaemia; selected patients with symptomatic extracranial vascular occlusions. The decision to undertake revascularisation surgery depends on individual patient characteristics; local expertise; an assessment of the safety and durability of either endovascular or surgical treatment and patient preference. A major challenge for the neurosurgical community is to ensure patients have access to neurovascular multi-disciplinary teams that have the expertise and experience to offer all forms of re-vascularisation surgery when it is indicated.

This lecture will consider the indications for cerebral revascularisation and the associated surgical strategies.

Neurocirugía (English edition)

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