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J Neurol Surg A Cent Eur Neurosurg 2017; 78(06): 595-600
DOI: 10.1055/s-0037-1598050
Technical Note
Georg Thieme Verlag KG Stuttgart · New York

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

Motohiro Nomura
1   Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki, Japan
,
Akira Tamase
2   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Tomoya Kamide
2   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Kentaro Mori
2   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Syunsuke Seki
2   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Yu Iida
2   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Yuichi Kawabata
3   Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Tatsu Nakano
3   Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Hiroshi Shima
2   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
,
Kunio Yanagimoto
4   Department of Pathology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
› Author Affiliations
Further Information

Publication History

24 May 2016

31 October 2016

Publication Date:
06 June 2017 (online)

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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.

Keywords

superficial temporal artery - middle cerebral artery - STA-MCA bypass - endarterectomy - intimal thickening
 

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