Dr. Benjamin Yim, a neurosurgeon at East Bay Brain & Spine Medical Group, recently performed an Extracranial to Intracranial Bypass surgery on a patient at the Walnut Creek Medical Center with the assistance from Agnieszka Bajer (surgical technician), Thomas Pierson (OR nurse), and Mauricio Kuri, MD (plastic surgery). The patient was suffering from Moyamoya disease, a rare progressive blood vessel disorder resulting in reduced blood flow to the brain causing hemorrhagic strokes and ischemic symptoms. The procedure, once completed, resulted in immediate improvement of blood flow to the brain for the patient. Dr. Yim performed the surgery using the Zeiss Kinevo Microscope, which we currently have on loan and are planning to purchase. The microscope technology is crucial because the anastomosis of 1 mm blood vessels require sutures approximately 1/3 the width of a strand of hair. This procedure highlights the quaternary level care offerings we provide locally at John Muir Health. Patients can stay in our community for services, procedures and clinical expertise that is normally only associated with academic medical centers.