Indocyanine green videoangiography for the identification of superficial temporal artery branches in EC-IC bypass surgery

2016 ◽  
Vol 158 (3) ◽  
pp. 565-570 ◽  
Author(s):  
Giuseppe Esposito ◽  
Jan-Karl Burkhardt ◽  
Oliver Bozinov ◽  
Luca Regli
Keyword(s):  
Indocyanine Green ◽  
Bypass Surgery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Indocyanine Green Videoangiography

Changes in superficial temporal artery blood flow and cerebral hemodynamics of moyamoya disease after extracranial-intracranial bypass surgery

2005 ◽  
Vol 25 (1_suppl) ◽  
pp. S120-S120 ◽  
Author(s):  
Shigeru Fujimoto ◽  
Kazunori Toyoda ◽  
Tooru Inoue ◽  
Yoko Yokoyama ◽  
Juro Jinnouchi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Moyamoya Disease ◽  
Bypass Surgery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Cerebral Hemodynamics ◽  
Artery Blood Flow

Abstract 74: Improvement in Cerebral Hemodynamic Parameters and Outcome after Superficial Temporal Artery- Middle Cerebral Artery Bypass in Patients with Severe Steno-occlusive Disease of Intracranial Carotid and Middle Cerebral Artery

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Leonard Yeo ◽  
Prakash Paliwas ◽  
Aftab Ahmad ◽  
Arvind K Sindha ◽  
Hockluen Teoh ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Bypass Surgery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Occlusive Disease ◽  
Stroke Recurrence ◽  
Hemodynamic Parameters ◽  
Bypass Group ◽  
Hmpao Spect

Background and Objective: Older and the recent extracranial-intracranial (EC/IC) bypass trials for symptomatic carotid occlusion failed to demonstrate reduction in stroke recurrence. However, role of superficial temporal artery-middle cerebral artery (STA-MCA) bypass in patients with symptomatic intracranial steno-occlusive disease has been evaluated scarcely. We evaluated serial changes in various cerebral hemodynamic parameters in patients with severe steno-occlusive disease of intracranial internal carotid (ICA) or middle cerebral artery (MCA) and impaired cerebral vasodilatory reserve (CVR), treated with STA-MCA bypass surgery or medical treatment. Methods: Patients with severe steno-occlusive disease of intracranial ICA or MCA underwent transcranial Doppler (TCD) ultrasonography and CVR assessment using breath-holding index (BHI). Patients with impaired BHI (<0.69) were further evaluated with acetazolamide-challenged hexamethylpropyleneamine-oxime single-photon emission computed tomography (HMPAO-SPECT). STA-MCA bypass surgery was offered to patients with impaired CVR on SPECT. All patients underwent TCD and SPECT at 4±1 months and followed-up for cerebral ischemic events. Results: A total of 112patients (73males, mean age 56yrs; range 23-78yrs) were included. HMPAO-SPECT demonstrated impaired CVR in 77 (69%) patients. Of them, 46 underwent STA-MCA bypass while 31 received best medical treatment. TCD and acetazolamide-challenged HMPAO-SPECT repeated 4±1months showed significant improvement in STA-MCA bypass group. During follow-up (mean 34months; range 18-39months), only 6/46 (13%) patients in bypass group developed cerebral ischemic events as compared to 14/31 (45%) cases on medical therapy (absolute risk-reduction 32%, p=0.008). Conclusion: STA-MCA bypass surgery in carefully selected patients with symptomatic severe intracranial steno-occlusive disease results in significant improvement in hemodynamic parameters and reduction in stroke recurrence.

scholarly journals Tips for Secure Anastomosis and Patency in Superficial Temporal Artery-Middle Cerebral Artery Bypass Surgery

2019 ◽  
Vol 47 (4) ◽  
pp. 290-295
Author(s):  
Ryo SUZUKI ◽  
Isao KITAHARA ◽  
Ataru FUKUDA ◽  
Hiroshi YONETANI ◽  
Tomoki YOKOCHI ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery

scholarly journals A novel, low-cost, reusable, high-fidelity neurosurgical training simulator for cerebrovascular bypass surgery

2019 ◽  
Vol 130 (5) ◽  
pp. 1663-1671
Author(s):  
Ulas Cikla ◽  
Balkan Sahin ◽  
Sahin Hanalioglu ◽  
Azam S. Ahmed ◽  
David Niemann ◽  
...  
Keyword(s):  
Bypass Surgery ◽  
Low Cost ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
High Fidelity ◽  
Skin Closure ◽  
Neurosurgical Training ◽  
Training Simulator ◽  
Live Animal

OBJECTIVECerebrovascular bypass surgery is a challenging yet important neurosurgical procedure that is performed to restore circulation in the treatment of carotid occlusive diseases, giant/complex aneurysms, and skull base tumors. It requires advanced microsurgical skills and dedicated training in microsurgical techniques. Most available training tools, however, either lack the realism of the actual bypass surgery (e.g., artificial vessel, chicken wing models) or require special facilities and regulations (e.g., cadaver, live animal, placenta models). The aim of the present study was to design a readily accessible, realistic, easy-to-build, reusable, and high-fidelity simulator to train neurosurgeons or trainees on vascular anastomosis techniques even in the operating room.METHODSThe authors used an anatomical skull and brain model, artificial vessels, and a water pump to simulate both extracranial and intracranial circulations. They demonstrated the step-by-step preparation of the bypass simulator using readily available and affordable equipment and consumables.RESULTSAll necessary steps of a superficial temporal artery–middle cerebral artery bypass surgery (from skin opening to skin closure) were performed on the simulator under a surgical microscope. The simulator was used by both experienced neurosurgeons and trainees. Feedback survey results from the participants of the microsurgery course suggested that the model is superior to existing microanastomosis training kits in simulating real surgery conditions (e.g., depth, blood flow, anatomical constraints) and holds promise for widespread use in neurosurgical training.CONCLUSIONSWith no requirement for specialized laboratory facilities and regulations, this novel, low-cost, reusable, high-fidelity simulator can be readily constructed and used for neurosurgical training with various scenarios and modifications.

Abstract T MP26: Role of 99tc-hmpao Spect in the Assessment of Cerebral Hemodynamic Parameters After Superficial Temporal Artery- Middle Cerebral Artery Bypass in Patients With Severe Steno-Occlusive Disease of Intracranial Carotid and Middle Cerebral Artery

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Amit Batra ◽  
Arvind K Sinha ◽  
Leonard L Yeo ◽  
Rahul Rathakrishnan ◽  
Prakash Paliwal ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Bypass Surgery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Occlusive Disease ◽  
Hemodynamic Parameters ◽  
Bypass Group ◽  
Hmpao Spect ◽  
Cerebral Ischemic

Background and Objective: Although superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery in patients with symptomatic carotid occlusion failed to demonstrate any benefit, its role in symptomatic intracranial steno-occlusive disease has been evaluated scarcely. We evaluated changes in hemodynamic parameters in patients with severe steno-occlusive disease of intracranial internal carotid (ICA) or middle cerebral artery (MCA) who underwent STA-MCA bypass for impaired cerebral vasodilatory reserve (CVR). Methods: Patients with severe steno-occlusive disease of intracranial ICA or MCA underwent transcranial Doppler (TCD) evaluation and CVR assessment using breath-holding index (BHI). Patients with impaired BHI (<0.69) were further evaluated with acetazolamide-challenged 99Tc-HMPAO-SPECT. STA-MCA bypass surgery was offered to patients with impaired CVR on SPECT. TCD and SPECT were repeated in all patients at 4±1 months and they were followed-up for cerebral ischemic events. Results: Of the 126 patients (80 male, mean age 56yrs; range 23-78yrs) that fulfilled our inclusion criteria, 84 (67%) showed impaired CVR HMPAO-SPECT. Fifty (60%) of them underwent STA-MCA bypass while 34(40%) received best medical treatment. TCD and acetazolamide-challenged HMPAO-SPECT repeated 4±1 months after surgery showed significant improvement in STA-MCA bypass group. TCD BHI improved from a median (IQR) of -0.05 to 1.1 (p<0.001). Compared to 98% patients with impaired CVR on pre-operative SPECT, only 20% showed abnormal results on post-operative imaging (p<0.001). During follow-up (mean 35 months; range 8 to 49months), only 6/50 (12%) patients in bypass group developed cerebral ischemic events as compared to15/34 (44%) cases on medical therapy (absolute risk reduction 32%, p=0.006). Conclusion: 99Tc-HMPAO SPECT with acetazolamide challenge is a reliable tool for the assessment of cerebral vasodilatory reserve in patients with severe steno-occlusive disease of intracranial ICA or MCA. STA-MCA bypass surgery in carefully selected patients results in significant improvement in hemodynamic parameters and reduction in stroke recurrence.

Novel Software-Derived Workflow in Extracranial–Intracranial Bypass Surgery Validated by Transdural Indocyanine Green Videoangiography

2020 ◽  
Vol 134 ◽  
pp. e892-e902
Author(s):  
Philippe Dodier ◽  
Thomas Auzinger ◽  
Gabriel Mistelbauer ◽  
Wei-Te Wang ◽  
Heber Ferraz-Leite ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Bypass Surgery ◽  
Indocyanine Green Videoangiography
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