H.J.N. Streefkerk

Publications (13)1.52 Total impact

• Chapter: Imaging of Extracranial to Intracranial Bypass

  H. J. N. Streefkerk, C. A. F. Tulleken, J. Hendrikse, C. J. M. Klijn
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  ABSTRACT: Extracranial to intracranial (EC-IC) bypass surgery can be applied to achieve revascularization of the brain in patients in whom the normal pathway of blood flow to the brain is obstructed. Patients who may benefit from revascularization can be divided into two main groups. The first group consists of patients with a giant aneurysm of one of the cerebral arteries, which can not be clipped or coiled and for whom temporary or permanent occlusion of the artery is the only treatment option. The second group comprises patients with recurrent transient ischaemic attacks (TIAs) and stroke associated with occlusion of the internal carotid artery (ICA) at high risk of recurrent ischaemic stroke. The treatment with EC-IC bypass is based on the notion that in some patients with ICA occlusion ischaemic stroke is caused by failure of blood flow towards the brain rather than by embolism [36]. In such “haemodynamically compromised” patients augmentation of blood flow towards the symptomatic hemisphere by means of an EC-IC bypass might theoretically be beneficial.
  12/2006: pages 225-238;
• Article: The ELANA technique: constructing a high flow bypass using a non-occlusive anastomosis on the ICA and a conventional anastomosis on the SCA in the treatment of a fusiform giant basilar trunk aneurysm.

  H J N Streefkerk, J F C Wolfs, W Sorteberg, A G Sorteberg, C A F Tulleken
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  ABSTRACT: A patient with a partially thrombosed fusiform giant basilar trunk aneurysm presented with devastating headache and symptoms of progressive brain stem compression. Having an aneurysm inaccessible for endovascular treatment, and after failing a vertebral artery balloon occlusion test, he was offered bypass surgery in order to exclude the aneurysm from the cerebral circulation and relieve his symptoms. A connection between the intracranial internal carotid artery and the superior cerebellar artery was created whereupon the basilar artery was ligated just distally to the aneurysm. The proximal anastomosis on the internal carotid artery was made using the excimer laser-assisted non-occlusive anastomosis (ELANA) technique, while a conventional end-to-side anastomosis was used for the distal anastomosis on the superior cerebellar artery. Intra-operative flowmetry showed a flow through the bypass of 40 ml/min after ligation of the basilar artery. An angiogram 24 hours later showed normal filling of the bypass and the vessels supplied by it, but also disclosed a subtotal occlusion of the proximal ipsilateral middle cerebral artery with delayed filling distally. The patient, who had a known thrombogenic coagulopathy, died the following day. Autopsy showed no signs of ischemia in the territories supplied by the bypass, but a thrombus in the proximal middle cerebral artery and massive acute hemorrhagic infarction with swelling in its territory and uncal herniation. Multiple fresh thrombi were found in the lungs. The ELANA anastomosis showed re-endothelialisation without thrombus formation on the inside.
  Acta Neurochirurgica 10/2004; 146(9):1009-19; discussion 1019. · 1.52 Impact Factor
• Article: Cerebral revascularization.

  H J N Streefkerk, A Van der Zwan, R M Verdaasdonk, H J Mansvelt Beck, C A F Tulleken
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  ABSTRACT: During the last 10 years, there has been a revival of interest in cerebral revascularization procedures. Not only have significant progressions in surgical techniques been published, the use of more advanced diagnostic methods has led to a widening of the indications for cerebral bypass surgery. The purpose of this review is to outline the current techniques for extracranial-to-intracranial (EC/IC) and intracranial-to-intracranial (IC/IC) bypass surgery, as well as to identify the current indications for revascularization procedures based on the available literature. The excimer laser-assisted non-occlusive anastomosis (ELANA) technique is described in more detail because we think that this technique almost completely eliminates the risk of cerebral ischemia due to the temporary vessel occlusion which is currently used in conventional anastomosis techniques.
  Advances and technical standards in neurosurgery 02/2003; 28:145-225.
• Article: The ELENA technique: application in experimental and clinical settings.

  H.J.N. Streefkerk
• Article: The Excimer laser-assisted nonocclusive anastomosis practice model: development and application of a tool for practicing microvascular anastomosis techniques

  H.J.N. Streefkerk, J.P. Bremmer, M. van Weelden, R.R. van Dijk, E. de Winter, R.J.M. Beck, C.A.F. Tulleken
• Article: The high-flow bypass in the treatment of intracranial aneurysm

  C.A.F. Tulleken, R.M. Verdaasdonk, H.J. Mansvelt Beck, H.J.N. Streefkerk
• Article: Long-term reendothelialization of excimer laser-assisted nonocclusive anastomoses compared with conventionally sutured anastomoses in pigs.

  H.J.N. Streefkerk, S Kleinveld, EL Koedam, M.M.M. Bulder, HD Meelduk, R.M. Verdaasdonk, RJ Beck, B. van der Zwan, C.A.F. Tulleken
• Article: New strategies for a non-occlusive bypass technique in the brain using a small low energy 308 nm excimer laser

  R.M. Verdaasdonk, A.A. de Jager, H.J. Mansvelt Beck, H.J.N. Streefkerk, C.A.F. Tulleken
• Article: Construction of a new posterior communicating artery in a patient with poor posterior fossa circulation: technical case report

  C.A.F. Tulleken, H.J.N. Streefkerk, A. van der Zwan
• Article: Flow quantification of the non-occlusive Excimer laser-assisted extra-intracranial bypass.

  A. van der Zwan, C.A.F. Tulleken, B Hillen, H.J.N. Streefkerk
• Article: The ELANA technique; a companion.

  H.J.N. Streefkerk, A. van der Zwan, R.M. Verdaasdonk, C.A.F. Tulleken
• Article: New strategies for a non-occlusive bypass technique in the brain using a small low energy 308 nm excimer laser

  R.M. Verdaasdonk, H.J. Mansvelt Beck, H.J.N. Streefkerk, C.A.F. Tulleken
• Article: The ELANA technique: high flow revascularization of the brain

  H.J.N. Streefkerk, J.P. Bremmer, C.A.F. Tulleken