scholarly journals Superficial-Temporal-Artery-To-Middle-Cerebral-Artery Bypass in Cerebrovascular Occlusive Disease and Hemodynamic-Related Ischemia: Illustrative Case and Literature Review

2021 ◽  
Author(s):  
Gustavo Rassier Isolan ◽  
Ricardo de Andrade Caracante ◽  
João Paulo Mota Telles ◽  
Nícollas Nunes Rabelo ◽  
Eberval Gadelha Figueredo
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Occlusive Disease ◽  
External Carotid ◽  
Illustrative Case ◽  
History Of ◽  
Cerebrovascular Occlusive Disease

AbstractStroke is the third most common cause of death worldwide. About 10% to 15% of strokes related to the territory of the carotid artery are associated with its complete occlusion. There is an important subgroup of patients with cerebrovascular occlusive diseases who might benefit from an external-carotid-to-internal-carotid bypass. In the present study, we report a case of a 53-year-old male patient with stenosis of the M2 branch of the middle cerebral artery (MCA), with a history of ∼ 20 episodes of transient ischemic accidents (TIA)s, in whom an anastomosis of the M4 branch of the superficial temporal artery-MCA was performed. The patient was discharged in three days, and in the two years of follow-up, they were no more TIAs. We also conducted a review of the literature on cerebrovascular occlusive disease and extracranial-intracranial bypass surgery. New methods to evaluate cerebral hemodynamics made it possible to classify a new subgroup of patients with symptomatic cerebrovascular disease and documented cerebrovascular compromise in whom the drug therapy fails, who can benefit from the extracranial-intracranial bypass. Our case report illustrates the advantages of revascularization in these selected patients.

Embolization of a Superficial Temporal Artery to Middle Cerebral Artery Bypass: Case Report

Neurosurgery ◽  
1983 ◽  
Vol 12 (3) ◽  
pp. 342-345 ◽  
Author(s):  
Frances K. Conley
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Bilateral Carotid ◽  
History Of ◽  
Internal Carotid Arteries ◽  
Bilateral Carotid Artery

Abstract This case history of a man with bilateral carotid artery occlusions presents angiographic documentation of the embolization of a superficial temporal-middle cerebral artery bypass. The embolic source was thrombotic and/or atheromatous debris that had collected in the persistent stump of one of the occluded internal carotid arteries.

Side-to-Side Superficial Temporal Artery to Middle Cerebral Artery Bypass Technique: Application of Fourth Generation Bypass in a Case of Adult Moyamoya Disease

2019 ◽  
Vol 18 (5) ◽  
pp. 480-486 ◽  
Author(s):  
Michael J Lang ◽  
Peter Kan ◽  
Jacob F Baranoski ◽  
Michael T Lawton
Keyword(s):  
Middle Cerebral Artery ◽  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
External Carotid Artery ◽  
Fourth Generation ◽  
External Carotid ◽  
Flow Properties

Abstract BACKGROUND Moyamoya disease (MMD) is a rare cause of cerebral hemorrhage and ischemia. Spontaneous development of collateral supply from the external carotid artery (ECA) may limit the use of donor arteries used in standard direct bypass techniques. OBJECTIVE To identify the technical feasibility of side-to-side (S-S) superficial temporal artery to middle cerebral artery (STA-MCA) bypass and demonstrate the application of fourth generational bypass techniques in the treatment of MMD. METHODS S-S bypass was performed in order to maintain distal outflow in the donor STA. Fourth generation bypass techniques, including atypical anastomosis construction and intraluminal suturing were utilized. RESULTS The novel S-S STA-MCA bypass was performed, with patent flow in both recipient MCA and endogenous ECA-ICA collaterals supplied by the distal STA. Technical nuances, including proper alignment of donor vessel, tension reduction, and S-S anastomosis construction with intraluminal suturing technique are essential for successful bypass. Unique flow properties of this bypass were identified, resulting in flow augmentation to the recipient territory compared to standard end-to-side (E-S) techniques. CONCLUSION Fourth generational bypass techniques can be successfully applied to MMD, allowing for novel bypass construction. S-S anastomosis can result in potentially beneficial flow properties compared to standard E-S constructions.

Superficial Temporal Artery-to-Middle Cerebral Artery Bypass

2005 ◽  
Vol 56 (suppl_1) ◽  
pp. ONS-186-ONS-190 ◽  
Author(s):  
Fady T. Charbel ◽  
Guido Meglio ◽  
Sepideh Amin-Hanjani
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Reliable Method ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Flow Measurements ◽  
Blood Flow Measurements ◽  
Cerebrovascular Occlusive Disease

Abstract THE SUPERFICIAL TEMPORAL artery-to-middle cerebral artery bypass represents the mainstay of bypass operations for cerebral revascularization. The role of this operation in the setting of cerebrovascular occlusive disease, with compromised cerebral hemodynamic reserve, is a topic of current investigation. In this report, we describe technical nuances to avert potential pitfalls in the performance of this procedure. The use of intraoperative quantitative blood flow measurements as a reliable method of assessing the success of the bypass is also described.

Minimally invasive superficial temporal artery to middle cerebral artery bypass through an enlarged bur hole: the use of computed tomography angiography neuronavigation in surgical planning

2008 ◽  
Vol 109 (3) ◽  
pp. 553-558 ◽  
Author(s):  
Jeroen R. Coppens ◽  
John D. Cantando ◽  
Saleem I. Abdulrauf
Keyword(s):  
Minimally Invasive ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Occlusive Disease ◽  
Invasive Technique ◽  
General Anesthetic ◽  
Hemodynamic Compromise

The authors describe their minimally invasive technique for performing a superficial temporal artery (STA) to middle cerebral artery (MCA) bypass, which relies on an enlarged bur hole (2–2.5 cm) rather than the standard craniotomy. They perform this procedure in a minimally invasive fashion, using CT angiography for intraoperative neuronavigation as well as for preoperative identification of the donor and recipient vessels and planning of bur hole location. They present 2 cases in which this procedure was used, including one involving a patient with multivessel occlusive disease and significant cerebrovascular hemodynamic compromise in whom they performed the procedure using only local anesthetic and propofol sedation in order to minimize the risk of hypotension associated with the use of general anesthetic agents. A comprehensive literature search revealed no previously published case of an extracranial–intracranial arterial bypass procedure performed in an awake patient. The authors have adopted the described minimally invasive method for all STA–MCA bypass procedures. The awake setting, however, is reserved for specific indications, primarily patients with severe moyamoya disease, in whom ventilator-related hypocarbia can result in intraoperative ischemia, or patients with multivessel occlusive disease and significant cerebral hemodynamic compromise, in whom general anesthesia–related hypotension can lead to intraoperative ischemia.

A 1-Donor 2-Recipient Superficial Temporal Artery-Middle Cerebral Artery Bypass for Moyamoya Syndrome: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Nickalus R Khan ◽  
Jacques J Morcos
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Surgical Anatomy ◽  
Large Area ◽  
Ischemic Disease ◽  
Near Occlusion ◽  
Direct Bypass

Abstract We present the case of a 34-yr-old male who suffered repeated ischemic events resulting in right-sided weakness. He was found to have left M1 segment near occlusion on angiography with a large area of uncompensated hypoperfusion. The patient underwent a direct superficial temporal artery-middle cerebral artery (STA-MCA) bypass. Direct bypass in the acute setting of ischemia has been previously described.1-5 Moyamoya ischemic disease can be treated with either direct or indirect surgical revascularization. There have been several techniques developed for direct bypasses in moyamoya ischemic disease. These include the standard 1-donor 1-recipient (1D1R) end-to-side (ES) bypass, the “double-barrel” 2-donor 2-recipient (2D2R) ES bypass, and the more recently developed 1-donor 2-recipient (1D2R)6,7 utilizing both an ES and a side-to-side (SS) bypass with a 1-donor vessel. The case presentation, surgical anatomy, decision-making, operative nuances, and postoperative course and outcome are reviewed. The patient gave verbal consent for participating in the procedure and surgical video.

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