Superficial Temporal Artery-Middle Cerebral Artery Bypass Using a Thick STA after Endarterectomy: A Rescue Technique

Author:

Tamase Akira1,Kamide Tomoya1,Mori Kentaro1,Seki Syunsuke1,Iida Yu1,Kawabata Yuichi2,Nakano Tatsu2,Shima Hiroshi1,Yanagimoto Kunio3,Nomura Motohiro4

Affiliation:

1. Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan

2. Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan

3. Department of Pathology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan

4. Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki, Japan

Abstract

Background and Objective Superficial temporal artery (STA)-middle cerebral artery (MCA) bypass is a procedure to reconstruct cerebral blood flow in the MCA territory. In some cases, the STA wall is thickened and the size discrepancy between STA and MCA is apparent. In such a situation, STA-MCA bypass is challenging. We present two patients who underwent STA-MCA bypass using STA in which a thickened intima was removed. We discuss the usefulness of this rescue technique. Patients and Results A patient with an atherosclerotic MCA occlusion and another with an occluded internal carotid artery are included. Endarterectomy of STA was performed before or during anastomosis, and the intima-resected STA was anastomosed to MCA. In both cases, the STA was thick and hard, and it was difficult to anastomose the STA as it was to the MCA. Patency of the bypass was confirmed by postoperative angiography. Conclusion Endarterectomy of a thickened STA might be an effective rescue technique in cases with severely atherosclerotic STA in STA-MCA bypass.

Publisher

Georg Thieme Verlag KG

Subject

Clinical Neurology,Surgery

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