Subscribe to RSS
DOI: 10.1055/s-2005-870599
Superficial Temporal Artery to Middle Cerebral Artery Bypass
Publication History
Publication Date:
02 June 2005 (online)
ABSTRACT
The superficial temporal artery to middle artery bypass is a technique that allows the blood supply from the extracranial carotid circulation to be routed to the distal middle cerebral artery branches. The procedure allows blood flow to bypass proximal lesions of the intracranial vasculature. The performance of this bypass requires specialized microvascular training and the use of microvascular techniques. The techniques involved in performing these procedures include microdissection of the superficial temporal artery in the scalp, microdissection of the recipient middle cerebral artery branches near the sylvian fissure, and anastomosis techniques using either microvascular sutures or a microanastomotic device. The successful completion of the bypass and subsequent patency requires meticulous attention to technical details.
KEYWORDS
Middle cerebral artery - superficial temporal artery to middle cerebral artery bypass - cerebral revascularization
REFERENCES
- 1 Yasargil M G. A legacy of microneurosurgery: memoirs, lessons, and axioms. Neurosurgery. 1999; 45 1025-1092
- 2 de Weerd A W, Veldhuizen R J, Veering M M, Poortvliet D C, Jonkman E J. Long-term clinical and neurophysiological effects of reconstructive vascular surgery for cerebral ischemia. Acta Neurol Scand. 1989; 79 311-315
- 3 Diaz F G, Umansky F, Mehta B et al.. Cerebral revascularization to a main limb of the middle cerebral artery in the Sylvian fissure. An alternative approach to conventional anastomosis. J Neurosurg. 1985; 63 21-29
- 4 Gratzl O, Schmiedek P. STA-MCA bypass: results 10 years postoperatively. Neurol Res. 1983; 5 11-18
- 5 Spetzler R F. Retinal circulation after STA-MCA bypass. Neurosurgery. 1985; 16 583
- 6 Sundt Jr T M, Siekert R G, Piepgras D G, Sharbrough F W, Houser O W. Bypass surgery for vascular disease of the carotid system. Mayo Clin Proc. 1976; 51 677-692
- 7 , [No authors listed.] Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. The EC/IC Bypass Study Group. N Engl J Med. 1985; 313 1191-1200
- 8 Srinivasan J, Britz G W, Newell D W. Cerebral revascularization for moyamoya disease in adults. Neurosurg Clin N Am. 2001; 12 585-594 , ix
- 9 Onesti S T, Solomon R A, Quest D O. Cerebral revascularization: a review. Neurosurgery. 1989; 25 618-628 , discussion 28-29
- 10 Newell D W, Skirboll S L. Revascularization and bypass procedures for cerebral aneurysms. Neurosurg Clin N Am. 1998; 9 697-711
- 11 McCormick P W, Tomecek F J, McKinney J, Ausman J I. Disabling cerebral transient ischemic attacks. J Neurosurg. 1991; 75 891-901
- 12 Grubb Jr R L. Extracranial-intracranial arterial bypass for treatment of occlusion of the internal carotid artery. Curr Neurol Neurosci Rep. 2004; 4 23-30
- 13 Newell D W, Dailey A T, Skirboll S L. Intracranial vascular anastomosis using the microanastomotic system. Technical note. J Neurosurg. 1998; 89 676-681
- 14 Newell D W, Schuster J M, Avellino A M. Intracranial-to-intracranial vascular anastomosis created using a microanastomotic device for the treatment of distal middle cerebral artery aneurysms. Technical note. J Neurosurg. 2002; 97 486-491
David W NewellM.D.
Seattle Neuroscience Institute
1600 East Jefferson St., Ste. 620
Seattle, WA 98122
Email: david.newell@swedish.org