Graft spasm is a common complication of bypass procedures and can result in ischemia or graft thrombosis. Described herein is use of botulinum toxin to prevent graft spasm in bypass surgery. The technique was used in extracranial-intracranial (EC-IC) bypass surgeries, with the harvested graft treated ex vivo with botulinum toxin before the anastomosis was performed. Post-bypass vascular imaging demonstrated patency and the absence of spasm in grafts, without any immediate endothelial or vessel wall damage. Postoperative angiograms were without graft spasm in all cases. Botulinum toxin can therefore be used to prevent graft spasm and maintaining patency in cerebral revascularization procedures.
