{"id":"98451c7f-ca2e-4198-b6f7-4faef34cfb10","slug":"the-omentum-in-the-surgical-treatment-of-recurrent-ischemic-stroke","title":"The omentum in the surgical treatment of recurrent ischemic stroke","authors":["Harry S. Goldsmith"],"abstract":"Background: Recurrent ischemic strokes and transient ischemic attacks (TIAs) are significant medical issues in the United States, contributing to high morbidity and mortality rates. The American Heart Association identifies TIAs and strokes as the fifth leading cause of death, with a substantial number of stroke patients experiencing recurrent events. A decrease in cerebral blood flow (CBF) and loss of microcirculation due to reduced levels of vascular endothelial growth factor (VEGF) are critical factors in the recurrence of strokes. Summary: The omentum has demonstrated the ability to enhance CBF and potentially increase VEGF levels when placed on the brain, which may improve microcirculation and reduce the incidence of recurrent strokes. Historical studies have shown that omental transposition can lead to significant improvements in CBF and neurological function in stroke patients. Current evaluations suggest that omental placement could serve as a viable surgical option for patients with recurrent TIAs and strokes, particularly when conventional drug therapies have failed. Conclusion: Given the omentum's capacity to increase CBF and VEGF, its surgical application may represent a promising intervention for preventing recurrent strokes. Further controlled trials are warranted to assess the efficacy of omental transposition in patients with TIAs and strokes, especially in younger populations. Keywords: ischemic stroke, transient ischemic attack, omenum, cerebral blood flow, vascular endothelial growth factor, surgical treatment, microcirculation, recurrent stroke","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/neurovascular.png","publishDate":"2021-01-20T00:00:00.000Z","doi":"10.25259/SNI_884_2020","categories":["Neurovascular","Editorial"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2021/01/10531/SNI-12-28.pdf"}