Download PDF
J Neurol Surg A Cent Eur Neurosurg 2019; 80(06): 441-453
DOI: 10.1055/s-0039-1685169
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Is Precise Targeting of the Recipient Artery in a Superficial Temporal Artery–Middle Cerebral Artery Anastomosis Crucial?

Hiroyuki Katano
1   Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
2   Department of Medical Informatics and Integrative Medicine, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
,
Hiroshi Yamada
1   Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
,
Yusuke Nishikawa
1   Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
,
Kazuo Yamada
3   Department of Neurosurgery, Nagoya City Rehabilitation Center, Nagoya, Aichi, Japan
,
Shigenori Miyachi
4   Department of Central Radiology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
,
Mitsuhito Mase
1   Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
› Author Affiliations
Further Information

Publication History

03 July 2018

19 November 2018

Publication Date:
29 August 2019 (online)

Also available at
    Permissions and Reprints

Abstract

Objective To investigate the difference in treatment outcomes according to the method used to select the recipient artery in superficial temporal artery–middle cerebral artery (STA-MCA) anastomoses.

Methods We retrospectively analyzed the cases of 35 patients who underwent an STA-MCA anastomosis for internal carotid artery/MCA occlusion or stenosis. Patients were divided into two groups based on whether the recipient artery was precisely targeted by single-photon emission computed tomography (SPECT group) or less precisely targeted by visual assessment (Visual group). Then the bypass results in both groups were evaluated postoperatively based on changes in the regional cerebral blood flow (rCBF) and clinical outcomes.

Results The delineated recipient artery in magnetic resonance angiography (MRA) matched the intraoperatively selected artery in 87.6% of the SPECT group cases and 83.3% of the Visual group cases. The SPECT group's digital subtraction angiography (DSA) findings coincided with the intraoperative selection in 76.9% of cases, and the MRA findings corresponded with the DSA findings in 92.3%. The postoperative areas with increased rCBF matched the perfused areas of intraoperatively selected arteries in 80.0% of the SPECT group cases and 77.8% of the Visual group cases. Postoperatively increased rCBF areas matching totally or partially with preoperative low-perfusion areas were observed in all cases.

Conclusions The present results revealed no significant differences in the change in rCBF in the low-perfusion area between the patients whose recipient arteries were selected by SPECT or visual assessment.

Keywords

EC-IC bypass - IC occlusion - MCA occlusion - MCA stenosis - SPECT - STA-MCA anastomosis - target bypass

Source of Funding

The authors did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.


 

  • References

  • 1 EC/IC Bypass Study Group. Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. N Engl J Med 1985; 313 (19) 1191-1200
    CrossrefPubMedSearch in Google Scholar
  • 2 Grubb Jr RL, Powers WJ, Clarke WR, Videen TO, Adams Jr HP, Derdeyn CP. ; Carotid Occlusion Surgery Study Investigators. Surgical results of the carotid occlusion surgery study. J Neurosurg 2013; 118 (01) 25-33
    CrossrefPubMedSearch in Google Scholar
  • 3 Hänggi D, Steiger H-J, Vajkoczy P. The role of MCA-STA bypass surgery after COSS and JET: the European point of view. Acta Neurochir Suppl (Wien) 2014; 119: 77-78
    PubMedSearch in Google Scholar
  • 4 Carlson AP, Yonas H, Chang Y-F, Nemoto EM. Failure of cerebral hemodynamic selection in general or of specific positron emission tomography methodology?: Carotid Occlusion Surgery Study (COSS). Stroke 2011; 42 (12) 3637-3639
    CrossrefPubMedSearch in Google Scholar
  • 5 Amin-Hanjani S, Barker II FG, Charbel FT, Connolly Jr ES, Morcos JJ, Thompson BG. ; Cerebrovascular Section of the American Association of Neurological Surgeons; Congress of Neurological Surgeons. Extracranial-intracranial bypass for stroke—is this the end of the line or a bump in the road?. Neurosurgery 2012; 71 (03) 557-561
    CrossrefPubMedSearch in Google Scholar
  • 6 Ogasawara K, Ogawa A. JET study (Japanese EC-IC Bypass Trial) [in Japanese]. Nihon Rinsho 2006; 64 (07) (Suppl. 07) 524-527
    PubMedSearch in Google Scholar
  • 7 Nakagawa I, Kurokawa S, Tanisaka M, Kimura R, Nakase H. Virtual surgical planning for superficial temporal artery to middle cerebral artery bypass using three-dimensional digital subtraction angiography. Acta Neurochir (Wien) 2010; 152 (09) 1535-1540 ; discussion 1541
    CrossrefPubMedSearch in Google Scholar
  • 8 Kuroda S, Kawabori M, Hirata K. , et al. Clinical significance of STA-MCA double anastomosis for hemodynamic compromise in post-JET/COSS era. Acta Neurochir (Wien) 2014; 156 (01) 77-83
    CrossrefPubMedSearch in Google Scholar
  • 9 Yoshimura S, Egashira Y, Enomoto Y, Yamada K, Yano H, Iwama T. Superficial temporal artery to middle cerebral artery double bypass via a small craniotomy: technical note. Neurol Med Chir (Tokyo) 2010; 50 (10) 956-959
    CrossrefPubMedSearch in Google Scholar
  • 10 The Committee on Guidelines for Stroke Management. Japanese Stroke Society EC-IC bypass. Tokyo: Kyowa Kikaku; 2015
    Search in Google Scholar
  • 11 Kikuta K, Takagi Y, Fushimi Y. , et al. “Target bypass”: a method for preoperative targeting of a recipient artery in superficial temporal artery-to-middle cerebral artery anastomoses. Neurosurgery 2006; 59 (04) (Suppl. 02) ONS320-ONS326 ' discussion ONS326–ONS327
    PubMedSearch in Google Scholar
  • 12 Tanaka Y, Nakahara I, Ohta T. , et al. Practical application of 3-D multifusion imaging for STA-MCA “tailored” bypass. Surg Cereb Stroke 2014; 42 (06) 432-438
    CrossrefPubMedSearch in Google Scholar
  • 13 Iida H, Itoh H, Nakazawa M. , et al. Quantitative mapping of regional cerebral blood flow using iodine-123-IMP and SPECT. J Nucl Med 1994; 35 (12) 2019-2030
    PubMedSearch in Google Scholar
  • 14 Yoneda H, Shirao S, Koizumi H. , et al. Reproducibility of cerebral blood flow assessment using a quantitative SPECT reconstruction program and split-dose 123I-iodoamphetamine in institutions with different γ-cameras and collimators. J Cereb Blood Flow Metab 2012; 32 (09) 1757-1764
    PubMedSearch in Google Scholar
  • 15 Iida H, Nakagawara J, Hayashida K. , et al. Multicenter evaluation of a standardized protocol for rest and acetazolamide cerebral blood flow assessment using a quantitative SPECT reconstruction program and split-dose 123I-iodoamphetamine. J Nucl Med 2010; 51 (10) 1624-1631
    CrossrefPubMedSearch in Google Scholar
  • 16 Ogura T, Hida K, Masuzuka T, Saito H, Minoshima S, Nishikawa K. An automated ROI setting method using NEUROSTAT on cerebral blood flow SPECT images. Ann Nucl Med 2009; 23 (01) 33-41
    CrossrefPubMedSearch in Google Scholar
  • 17 Minoshima S, Berger KL, Lee KS, Mintun MA. An automated method for rotational correction and centering of three-dimensional functional brain images. J Nucl Med 1992; 33 (08) 1579-1585
    PubMedSearch in Google Scholar
  • 18 Minoshima S, Frey KA, Koeppe RA, Foster NL, Kuhl DE. A diagnostic approach in Alzheimer's disease using three-dimensional stereotactic surface projections of fluorine-18-FDG PET. J Nucl Med 1995; 36 (07) 1238-1248
    PubMedSearch in Google Scholar
  • 19 Takeuchi R, Sengoku T, Matsumura K. Usefulness of fully automated constant ROI analysis software for the brain: 3DSRT and FineSRT. Radiat Med 2006; 24 (07) 538-544
    CrossrefPubMedSearch in Google Scholar
  • 20 Takeuchi R, Yonekura Y, Takeda SK, Fujita K, Konishi J. Fully automated quantification of regional cerebral blood flow with three-dimensional stereotaxic region of interest template: validation using magnetic resonance imaging—technical note. Neurol Med Chir (Tokyo) 2003; 43 (03) 153-162
    CrossrefPubMedSearch in Google Scholar
  • 21 Katano H, Mase M, Sakurai K, Miyachi S, Yamada K. Revaluation of collateral pathways as escape routes from hyperemia/hyperperfusion following surgical treatment for carotid stenosis. Acta Neurochir (Wien) 2012; 154 (12) 2139-2148 ; discussion 2148–2149
    CrossrefPubMedSearch in Google Scholar
  • 22 Torigai T, Mase M, Ohno T. , et al. Usefulness of dual and fully automated measurements of cerebral blood flow during balloon occlusion test of the internal carotid artery. J Stroke Cerebrovasc Dis 2013; 22 (03) 197-204
    CrossrefPubMedSearch in Google Scholar
  • 23 Thines L, Durand A, Penchet G. , et al. Microsurgical neurovascular anastomosis: the example of superficial temporal artery to middle cerebral artery bypass. Technical principles. Neurochirurgie 2014; 60 (04) 158-164
    CrossrefPubMedSearch in Google Scholar
  • 24 Peña-Tapia PG, Kemmling A, Czabanka M, Vajkoczy P, Schmiedek P. Identification of the optimal cortical target point for extracranial-intracranial bypass surgery in patients with hemodynamic cerebrovascular insufficiency. J Neurosurg 2008; 108 (04) 655-661
    CrossrefPubMedSearch in Google Scholar
  • 25 Umemura A, Yamada K, Masago A, Kanda Y, Matsumoto T, Shimazu N. Hemodynamic flow patterns evaluated by transcranial color-coded duplex sonography after STA-MCA bypass for internal carotid artery occlusion. Cerebrovasc Dis 2002; 14 (3–4): 143-147
    CrossrefPubMedSearch in Google Scholar
  • 26 Sayama T, Inoue T, Uda K. , et al. Cerebral blood flow after superficial temporal artery–middle cerebral artery anastomosis. Jpn J Neurosurg (Tokyo) 2008; 17 (07) 533-537
    CrossrefPubMedSearch in Google Scholar
  • 27 Spetzler R, Chater N. Microvascular bypass surgery. Part 2: Physiological studies. J Neurosurg 1976; 45 (05) 508-513
    CrossrefPubMedSearch in Google Scholar
  • 28 Miyazawa N, Aoki S, Toyama K. , et al. Velocity-coded colour magnetic resonance angiography and perfusion-weighted magnetic resonance imaging for the evaluation of extracranial-to-intracranial arterial bypass surgery. Clin Neurol Neurosurg 2002; 105 (01) 48-59
    CrossrefPubMedSearch in Google Scholar
  • 29 Praharaj SS, Coulthard A, Gholkar A, English P, Mendelow AD. Magnetic resonance angiographic assessment after extracranial-intracranial bypass surgery. J Neurol Neurosurg Psychiatry 1996; 60 (04) 439-441
    CrossrefPubMedSearch in Google Scholar
  • 30 Tsuchiya K, Honya K, Fujikawa A, Tateishi H, Shiokawa Y. Postoperative assessment of extracranial-intracranial bypass by time-resolved 3D contrast-enhanced MR angiography using parallel imaging. AJNR Am J Neuroradiol 2005; 26 (09) 2243-2247
    PubMedSearch in Google Scholar
  • 31 Horn P, Vajkoczy P, Schmiedek P, Neff W. Evaluation of extracranial-intracranial arterial bypass function with magnetic resonance angiography. Neuroradiology 2004; 46 (09) 723-729
    CrossrefPubMedSearch in Google Scholar
  • 32 Langner S, Fleck S, Seipel R, Schroeder HW, Hosten N, Kirsch M. Perfusion CT scanning and CT angiography in the evaluation of extracranial-intracranial bypass grafts. J Neurosurg 2011; 114 (04) 978-983
    CrossrefPubMedSearch in Google Scholar
  • 33 Dawkins AA, Evans AL, Wattam J. , et al. Complications of cerebral angiography: a prospective analysis of 2,924 consecutive procedures. Neuroradiology 2007; 49 (09) 753-759
    CrossrefPubMedSearch in Google Scholar
  • 34 Reynolds MR, Grubb Jr RL, Clarke WR. , et al; Carotid Occlusion Surgery Study Investigators. Investigating the mechanisms of perioperative ischemic stroke in the Carotid Occlusion Surgery Study. J Neurosurg 2013; 119 (04) 988-995
    CrossrefPubMedSearch in Google Scholar
  • 35 Scott RM, Smith ER. Moyamoya disease and moyamoya syndrome. N Engl J Med 2009; 360 (12) 1226-1237
    CrossrefPubMedSearch in Google Scholar
  • 36 Kawaguchi T, Fujita S, Hosoda K. , et al. Multiple burr-hole operation for adult Moyamoya disease. J Neurosurg 1996; 84 (03) 468-476
    CrossrefPubMedSearch in Google Scholar
  • 37 Kuroda S, Houkin K. Moyamoya disease: current concepts and future perspectives. Lancet Neurol 2008; 7 (11) 1056-1066
    CrossrefPubMedSearch in Google Scholar