A 65 year old male patient, for the last 6 months was suffering from recurrent attacks of weakness of the left side limbs – RIND (Recurrent Ischemic Neurological Deficits). C T Angiogram done at Fortis Malar showed that he had a Total block of the Left Internal carotid Artery (which takes blood to the left side of the brain). His right Internal carotid artery (ICA) was also supplying the left side of the brain, apart from the right side. Detailed investigation showed that the right side vessel also had a 55% narrowing due to a fatty deposit (atheromatous plaque) of the right ICA inside the head

This condition made the patient’s brain completely dependent on a single vessel that was more than 50% narrowed for blood supply, a pathology responsible for RIND.

The Neurosurgical Team at Fortis Malar headed by Dr K Sridhar planned an “angioplasty” or “stenting” to widen the vessel on the right side. However, before doing this, it was necessary to provide an additional blood flow to the left side of the brain. The human brain needs an uninterrupted supply of large amounts of blood every minute to perform its multitude of complex functions. This blood is supplied through four arteries. In many of us, even if one of these four arteries get blocked over a period of time due to some disease, the remaining three arteries take over the extra load and succeed in maintaining normal blood supply to entire brain.

Dr. K. Sridhar and his team of doctors from Fortis Malar Hospital performed the Brain bypass operation, in which a vessel from outside the skull (the external Carotid System) was linked to the blood vessel inside the skull (Internal carotid system). The surgery was performed and the anastomosis was performed using sutures as thin as fine hair (10-0) not seen by the naked eye. The Cerebral Bypass surgery is a procedure that is performed not so frequently, as the blood supply of the brain is from many sources and also nature ensures that it is never in short supply. Bypass surgery is technically demanding and needs specific training before one can perform this procedure. The anastomosis –bypass was successfully performed and confirmed on the operation table by a micro Doppler.

The patient recovered successfully from the surgery and is on medication awaiting the second stage of his treatment.