Usefulness of an Ultrasonic Scalpel to Harvest and Skeletonize the Superficial Temporal Artery for Extracranial-Intracranial Bypass Surgery

Abstract

Abstract Objective: A new method to harvest and skeletonize the superficial temporal artery (STA) using an ultrasonic scalpel is presented. The technique is simple and safe, and reduces bleeding. We also investigated histopathological changes in donor vessels and whether it is possible to shorten the time needed for STA harvesting using the ultrasonic scalpel. Methods: Between January 1, 2005, and December 31, 2007, 31 consecutive patients underwent STA and middle cerebral artery anastomosis surgery in our hospital. All patients underwent harvesting of both the frontal and parietal branches of the STA. STA harvesting using an ultrasonic scalpel was performed in 18 of the 31 patients. We compared the time needed for STA harvesting by dividing patients into 2 groups: a non-ultrasonic scalpel group and an ultrasonic scalpel group. We also examined the histopathological changes by application of ultrasonic waves on the STA in the 6 most recent patients. Results: The mean time needed for STA harvesting was 84.2 ± 14.1 minutes for the non-ultrasonic scalpel group and 55.1 ± 15.2 minutes for the ultrasonic scalpel group. The ultrasonic scalpel group showed a significantly shorter harvesting time than the non-ultrasonic scalpel group (P < 0.01). No histopathological change was observed in any layers of the STA. Conclusion: Our data suggest that STA harvesting with the ultrasonic scalpel may be useful for STA-middle cerebral artery anastomosis surgery.