anastomoses, sewing vessels

[beaverfetus]

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Do neurosurgeons sew vessels and make anastomoses? Basically do they get to play with vasculature beyond just clipping aneurysms? I've heard they do carotid endarectomies. Are there procedures where they bypass occluded vessels?

Thanks in advance, and forgive my ignorance

 

[mpp]

Yes, they do bypasses, typically intracranial-extracranial anastamoses. Bypasses for stroke are not as common as they used to be after a randomized trial showed no better outcomes than medical management (although as is typical for these kinds of studies controversies exist). But there are other indications.

Neurosurgeons also do carotid endarterectomies although of course there is fierce competition with the vascular surgeons and even ENT surgeons. A huge multi-center trial is currently underway to see if carotid stenting is equivalent to endarterectomy.