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J Neurol Surg A Cent Eur Neurosurg 2024; 85(04): 412-416
DOI: 10.1055/a-1832-3158
Case Report

Staged Common and External Carotid Artery Stenting Followed by Superficial Temporal Artery to Middle Cerebral Artery Bypass

Michael Mulcahy 
1   Sydney Medical School, the University of Sydney, Camperdown NSW, Sydney, New South Wales, Australia
,
Anna Lo Presti
2   Department of Neurosurgery, Macquarie University, Sydney, New South Wales, Australia
,
Jorn Paul Van Der Veken
2   Department of Neurosurgery, Macquarie University, Sydney, New South Wales, Australia
,
Brendan Steinfort
3   Department of Radiology, Macquarie University, Sydney, New South Wales, Australia
,
Nazih Assaad
2   Department of Neurosurgery, Macquarie University, Sydney, New South Wales, Australia
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Abstract

Superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery for internal carotid artery (ICA) occlusive disease necessarily requires sufficient external carotid artery (ECA) blood flow. Surgical bypass is therefore precluded if there is common carotid artery (CCA) occlusion. Here we present two such cases: one patient had a CCA occlusion and the other had an ICA occlusion and ECA stenosis. Both had failed medical management, and were therefore treated with angioplasty and stenting of the ECA, followed by STA-MCA bypass. We describe the clinical and radiologic outcomes of these cases, and remark on the potential pitfalls associated with this novel approach.

Keywords

cerebral revascularization - extracranial–intracranial bypass - carotid artery occlusion - cerebral ischemia - carotid stent


Publication History

Received: 06 December 2021

Accepted: 19 April 2022

Accepted Manuscript online:
22 April 2022

Article published online:
13 September 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
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