Whose study demonstrated the efficacy of direct revascularization over indirect?

Whose study demonstrated the efficacy of direct revascularization over indirect?

• A. Nevelle 2009
• B. BASIL Multicenter
• C. Uccioli 2018
• D. NEJM 2010

Answer: (A)

Direct revascularization provides immediate restoration of blood flow by connecting a donor artery to the brain’s receiving artery, so the tissue at risk is protected right away. Indirect revascularization relies on the brain to grow new collateral vessels over time, which can be slow and incomplete, especially in adults. Neville 2009 showed that the direct approach yields better outcomes than indirect in this context, with faster and more reliable perfusion improvement and lower risk of ischemic events. The other studies listed involve different questions or patient groups (for example, comparisons of bypass vs angioplasty for limb ischemia or other cerebrovascular topics). They do not specifically provide the same direct-versus-indirect comparison in the same setting, which is why Neville 2009 is the best-supported choice for this question.

Direct revascularization provides immediate restoration of blood flow by connecting a donor artery to the brain’s receiving artery, so the tissue at risk is protected right away. Indirect revascularization relies on the brain to grow new collateral vessels over time, which can be slow and incomplete, especially in adults. Neville 2009 showed that the direct approach yields better outcomes than indirect in this context, with faster and more reliable perfusion improvement and lower risk of ischemic events.

The other studies listed involve different questions or patient groups (for example, comparisons of bypass vs angioplasty for limb ischemia or other cerebrovascular topics). They do not specifically provide the same direct-versus-indirect comparison in the same setting, which is why Neville 2009 is the best-supported choice for this question.