Superficial temporal artery to middle cerebral artery anastomosis

1979 ◽  
Vol 50 (5) ◽  
pp. 560-569 ◽  
Author(s):  
John R. Little ◽  
Y. Lucas Yamamoto ◽  
William Feindel ◽  
Ernst Meyer ◽  
Charles P. Hodge
Keyword(s):  
Middle Cerebral Artery ◽  
Fluorescein Angiography ◽  
Cerebral Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Anastomotic Site ◽  
Regional Cerebral Blood ◽  
Severe Stenosis ◽  
Content Type ◽  
Clearance Studies

✓ Fluorescein angiography and xenon-133 (133Xe) clearance studies were performed during surgery on 15 patients who were undergoing superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis. Fourteen patients had occlusive disease of the internal carotid artery (ICA), and one patient had severe stenosis of the MCA. Before anastomosis, fluorescein angiography showed slow filling of the MCA branches through collateral channels. Focal areas of impaired microcirculatory filling and washout were seen in the territory of severely sclerotic cortical arteries. The findings of preanastomotic 133Xe clearance studies were variable and a uniform pattern of regional cerebral blood flow (rCBF) changes was not defined. In 55% of the patients, rCBF was reduced to 25 ml/100 gm/min or less at one or more detector sites. Fluorescein angiography provided an immediate assessment of anastomotic patency and clearly displayed the distribution of blood entering the epicerebral circulation through the STA. In 67% of patients, multiple MCA cortical branches filled with fluorescein, whereas in 33% filling was restricted to the receptor artery territory. An immediate, substantial (≥ 15 ml/100 gm/min) increase in rCBF was demonstrated in 73% of patients after anastomosis. The rCBF changes were consistently better in patients with donor and receptor arteries greater than 1 mm in diameter. Redistribution of collateral input acted to increase rCBF in areas distant from the anastomotic site. Some improvement in fluorescein circulation and rCBF also was seen in cortex supplied by sclerotic MCA branches.

Anastomosis of the anterior temporal artery to a secondary trunk of the middle cerebral artery for treatment of a giant M1 segment aneurysm

1992 ◽  
Vol 76 (5) ◽  
pp. 863-866 ◽  
Author(s):  
Joshua B. Bederson ◽  
Robert F. Spetzler
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Clinical Course ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Suture Line ◽  
Arterial Segment ◽  
Content Type ◽  
Proximal Middle Cerebral Artery

✓ The clinical course, operative technique, and angiographic outcome are reported for a patient with a giant intracranial aneurysm of the proximal middle cerebral artery (MCA) who presented with symptoms of ischemia. Treatment of the aneurysm required bypassing the involved MCA bifurcation, but the patient lacked a suitable donor superficial temporal artery. The involved arterial segment was therefore bypassed with a side-to-side anastomosis of the anterior temporal artery to one of the secondary trunks of the MCA. This bypass eliminated the need to harvest a vein graft and re-established flow using in situ intracranial vessels of similar diameter, minimal arterial dissection, and only one suture line.

Subclavian to middle cerebral artery saphenous vein bypass graft

1980 ◽  
Vol 53 (4) ◽  
pp. 465-469 ◽  
Author(s):  
Robert F. Spetzler ◽  
Robert S. Rhodes ◽  
Richard A. Roski ◽  
Matt J. Likavec
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Saphenous Vein ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Superficial Temporal Artery ◽  
Head Rotation ◽  
Temporal Artery ◽  
Additional Advantage ◽  
Content Type

✓ A variation of an extracranial-intracranial arterial bypass is presented. The subclavian artery is used as the donor vessel and the saphenous vein as the graft; thus, a bypass to a cortical branch of the middle cerebral artery can be accomplished. The advantage of this modification is that the saphenous vein, when tunneled subcutaneously behind the ear, is positioned in a straight line from the donor to the recipient vessel. Since the vein lies in the axis of head rotation, turning of the head causes little displacement of the graft, as opposed to a graft from the common carotid artery to the middle cerebral artery. An additional advantage over the superficial temporal artery to middle cerebral artery bypass is the large flow obtained immediately after anastomosis.

Superficial temporal-middle cerebral artery anastomosis associated with glioblastoma multiforme

1977 ◽  
Vol 46 (3) ◽  
pp. 381-384
Author(s):  
Joseph F. Cusick ◽  
Senichiro Komacki ◽  
Hongyung Choi
Keyword(s):  
Glioblastoma Multiforme ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Surgical Anastomosis ◽  
Content Type ◽  
Fine Print ◽  
Temporal Middle

✓ The authors report a case in which glioblastoma multiforme was intimately associated with a surgical anastomosis of the superficial temporal artery to a branch of the middle cerebral artery.

Giant serpentine middle cerebral artery aneurysm treated by extracranial-intracranial bypass

1993 ◽  
Vol 78 (6) ◽  
pp. 974-978 ◽  
Author(s):  
Karl A. Greene ◽  
John A. Anson ◽  
Robert F. Spetzler
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Superficial Temporal Artery ◽  
Artery Aneurysm ◽  
Temporal Artery ◽  
Left Middle Cerebral Artery ◽  
Content Type ◽  
Serpentine Aneurysm ◽  
Aneurysmal Neck ◽  
Cerebral Artery Aneurysm

✓ Giant intracranial aneurysms often pose difficult management issues. Such aneurysms may not be amenable to direct surgical attack because of their size, location, or lack of a clear aneurysmal neck. In such cases, a combination of strategies may provide a means of proximal aneurysm occlusion and distal cerebral revascularization. The authors report the successful treatment of a giant (186.8-ml) serpentine aneurysm of the left middle cerebral artery (MCA) in a 14-year-old boy. The aneurysm was managed in a two-stage procedure in which the MCA branches distal to the aneurysm were anastomosed first with branches of the left superficial temporal artery. After the bypass procedure, direct occlusion of the MCA was performed at the proximal base of the aneurysm at its site of dilatation. The patient had no intraoperative or postoperative complications and was intact neurologically 6 months following the procedures.

Spontaneous cerebral revascularization in a patient with STA-MCA anastomosis

1976 ◽  
Vol 44 (1) ◽  
pp. 84-87 ◽  
Author(s):  
James I. Ausman ◽  
James Moore ◽  
Shelley N. Chou
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Cerebral Revascularization ◽  
Surgical Anastomosis ◽  
Content Type ◽  
The Brain ◽  
Fine Print

✓ The authors report a case with spontaneous revascularization of the brain after surgical anastomosis of the superficial temporal artery to the middle cerebral artery.

End-to-side anastomosis of small vessels using an Nd:YAG laser with a hemispherical contact probe

1992 ◽  
Vol 76 (3) ◽  
pp. 546-549 ◽  
Author(s):  
Cornelis A. F. Tulleken ◽  
Andries van Dieren ◽  
Ruud M. Verdaasdonk ◽  
Wim Berendsen
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Nd:Yag Laser ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Content Type ◽  
Small Vessels ◽  
Contact Probe ◽  
A New Technique ◽  
Fine Print

✓ A new technique is described which enables the surgeon to perform an end-to-side anastomosis between arteries with little (< 2 minutes) or no occlusion of the recipient artery. The technique was developed in rabbits, but has recently been successfully used in a patient in whom an anastomosis between the superficial temporal artery and a proximal branch of the middle cerebral artery was created.

Dissecting aneurysms of the anterior circle of Willis arteries

1987 ◽  
Vol 67 (2) ◽  
pp. 296-300 ◽  
Author(s):  
Ryuichi Kitani ◽  
Tooru Itouji ◽  
Yatsugi Noda ◽  
Makoto Kimura ◽  
Satoshi Uchida
Keyword(s):  
Cerebral Infarction ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Dissecting Aneurysm ◽  
Collateral Flow ◽  
Content Type ◽  
Initial Symptoms ◽  
The Right

✓ Two cases of spontaneous dissecting aneurysm extending from the supraclinoid portion of the internal carotid artery to the middle cerebral artery are reported in two teenaged patients. Both patients collapsed with a headache on the right side, left hemiparesis, and altered consciousness due to cerebral ischemia. One patient became alert in 2 days; however, his condition rapidly deteriorated 4 days later and he died on the 8th day from massive cerebral infarction. The other patient received a right superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis 50 hours after his initial symptoms. He improved gradually and is able to walk without help. Cerebral angiograms 3 months after the operation disclosed progressive attenuation of the MCA and dilatation of the anastomosed STA. Artificial collateral flow demonstrated in the postoperative angiogram may have been useful in preventing massive cerebral infarction.

Fatal subdural bleeding following superficial temporal-middle cerebral artery anastomosis

1980 ◽  
Vol 52 (3) ◽  
pp. 392-394 ◽  
Author(s):  
Toussaint A. Leclercq ◽  
Mary W. Ambler
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Subdural Hemorrhage ◽  
Content Type ◽  
Subdural Bleeding ◽  
Arterial Anastomosis

✓ This report describes a sudden death during convalescence from superficial temporal artery-middle cerebral artery bypass surgery. Artificial arterial anastomosis introduces the danger of a high-pressure subdural hemorrhage in an unnatural location.

“Target Bypass”: A Method for Preoperative Targeting of A Recipient Artery in Superficial Temporal Artery-to-Middle Cerebral Artery Anastomoses

2006 ◽  
Vol 59 (suppl_4) ◽  
pp. ONS-320-ONS-327 ◽  
Author(s):  
Ken-ichiro Kikuta ◽  
Yasushi Takagi ◽  
Yasutaka Fushimi ◽  
Kouichi Ishizu ◽  
Tsutomu Okada ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Magnetic Resonance ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Regional Cerebral Blood Flow ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Regional Cerebral Blood ◽  
Recipient Artery

Abstract OBJECTIVE: To introduce a method for preoperative targeting of a proper recipient artery in superficial temporal artery-to-middle cerebral artery anastomosis. METHODS: Six operations for superficial temporal artery-to-middle cerebral artery anastomosis in four patients with moyamoya disease or moyamoya-like disease and two operations in two patients with atherosclerotic cerebrovascular occlusive disease accompanied by coronary artery stenosis were performed using our method. Before surgery, a 3-Tesla magnetic resonance imaging study was performed with axial T1-weighted three-dimensional magnetization-prepared rapid acquisition gradient-echo sequences and three-dimensional time-of-flight magnetic resonance angiography. Data on quantitative regional cerebral blood flow were obtained by iodine-123-labeled N-isopropyl-iodoamphetamine single-photon emission computed tomography or positron emission computed tomography. The magnetic resonance angiography and regional cerebral blood flow data sets were registered with the magnetization-prepared rapid acquisition gradient-echo data set by means of the coregistration function of the SPM2 software. We examined the arteries located on or near the cortex where the regional cerebral blood flow had significantly decreased and used the coregistered data set and MRIcro software to select the cortical artery with the largest diameter as the target recipient artery. At the surgery, the data sets were applied to the neuronavigation system and the actual site of the target was confirmed in the operation before scalp incision. The superficial temporal artery was anastomosed with the target through a small craniotomy. RESULTS: Successful bypass surgery to the target was confirmed in all cases. @@CONCLUSION:@@ The “target bypass” method might be effective for cases with moya-moya disease or for cases requiring surgery through a small craniotomy.

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