Andy, it is very rewarding work. Our neurosurgeons also bypass patients with advanced Moya Moya disease. I never thought I'd be doing graft imaging in a TCD setting but we typically have one to do each day, even on the weekends (I work every Saturday and Sunday, which suits this old duffer just fine).

On Sat, Apr 15, 2023 at 7:29 AM Andrew Bebry <[log in to unmask]> wrote:
BTW Steve,  It must be fascinating for you to work with surgeons that do this.  This is an area I have not been exposed to with all the vascular surgeons I have worked with on LI.  We used to have a few surgeons here with incredible skills (we still have  a few), but the progressive programs here on LI have pushed them out in lieu of saving money but to make money for the program (if you know what I mean).  Andy

On Sat, Apr 15, 2023 at 10:24 AM Andrew Bebry <[log in to unmask]> wrote:
Thank you very much Steve.  I will also attempt an internet search.  Andy

On Sat, Apr 15, 2023 at 9:51 AM Steven J Knight <[log in to unmask]> wrote:
Andy, I'm sure it's an in depth topic amongst specialists. Since coming to work at a hospital that is the go to place for this type of thing in the Pacific Northwest, I have gained a great deal of respect for this short artery and I consider it the "blue wire" the Circle of Willis. It's more than just a conduit to the COW. Its branches feed our lizard brain (respiration, circulation). I know that if collaterals are robust, it can be sacrificed to eliminate an aneurysm. Our neurosurgeons will bypass from the CCA to the PCA to augment perfusion in some circumstances. I will see what I can dig up for you. 
Steve

On Sat, Apr 15, 2023, 6:11 AM Andrew Bebry <[log in to unmask]> wrote:
Good morning all. Does anyone have experience and/or literature on basilar artery stenosis?  What is the treatment? A case came up recently with a cva/tia (I don't have entire hx).  CT and MR detected this stenosis and cranial aneurysm (no bleeding). I'd like to look into this more. Thank you in advance. 
Andy Bebry rvt
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       Steve Knight

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