Seven Bypasses (PDF)

Seven Bypasses: Tenets and Techniques for Revascularization is the third book in a trilogy of bravura, technical nuance, and strategy by master neurosurgeon Michael Lawton. Like his first two books on aneurysms and AVMs, Seven Bypasses provides unparalleled firsthand insights and guidance on complex pathologies in vascular neurosurgery. The fundamentals of microsurgical anastomosis and the craft of bypass surgery are explored in depth with clinical pearls in every chapter.

Lawton eloquently reveals the art of cerebral revascularization in exquisite, metaphorical detail. The surgeon performing bypass surgery is like an architect envisioning and building a beautiful structure. A bypass is designed to fit the patient's unique anatomy; blueprints designate anastomotic sites, connections, and conduits; the anastomoses are constructed; and the bypass is brought to life with pulsations, flow, and reperfusion. The book highlights Lawton's aesthetic, which has evolved from the common STA-MCA bypasses to IC-IC bypasses and elaborate arterial reconstructions.

Key Highlights

• Stepwise discussion of the three anastomoses that form the building blocks of all bypasses: end-to-side, side-to-side, and end-to-end anastomoses


• Ten tenets delineate nuances of bypass: dexterity, preparing donors and recipients, establishing a working zone, temporary arterial occlusion, arteriotomy, suturing technique, tissue handling, knot tying, patency, and aneurysm occlusion


• Step-by-step guidance on the seven bypasses: EC-IC bypass, EC-IC interpositional bypass, arterial reimplantation, in-situ bypass, reanastomosis, IC-IC interpositional bypass, and combination bypass


• Strategies and algorithms for aneurysms organized by specific anatomical sites, including the MCA and the Sylvian cistern, ACA and the interhemispheric cistern, basilar artery and the basal cisterns, and PICA and the cisterna magna


• More than 1,500 radiographs, operative photographs, and exquisite illustrations drawn by artist Kenneth Xavier Probst elucidate anatomy, surgical principles, and clinical cases

Dr. Lawton has bequeathed a remarkable treasure of knowledge to current and future generations of neurosurgeons and their patients. The Seven series is destined to be an enduring classic for residents, fellows, and neurosurgeons specializing in the treatment of cerebrovascular disease, and for those who believe that manual dexterity and technical skill still matter.