scholarly journals “Reverse” Bypass Using a Naturally Formed “Bonnet” Superficial Temporal Artery in Symptomatic Common Carotid Artery Occlusion: A Case Report

2014 ◽  
Vol 54 (10) ◽  
pp. 851-853 ◽  
Author(s):  
Naoki OTANI ◽  
Kojiro WADA ◽  
Fumihiro SAKAKIBARA ◽  
Kimihiro NAGATANI ◽  
Satoru TAKEUCHI ◽  
...  
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Common Carotid Artery Occlusion

scholarly journals Side-to-side reverse superficial temporal artery to M4 middle cerebral artery bypass for common carotid artery occlusion with bonnet collaterals: illustrative case

2021 ◽  
Vol 1 (19) ◽  
Author(s):  
Lekhaj C. Daggubati ◽  
Varun Padmanaban ◽  
Ephraim W. Church
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Fourth Generation ◽  
External Carotid ◽  
Retrograde Flow ◽  
Common Carotid Artery Occlusion

BACKGROUND The bonnet bypass was initially described for common carotid artery occlusion. Considered a second-generation bypass, it augments intracranial perfusion with contralateral external carotid artery flow through an interposition graft running over the scalp vertex. However, the traditional first-generation low-flow superficial temporal artery (STA)-M4 middle cerebral artery (MCA) bypass may be enhanced by performing a side-to-side (S-S) bypass with an intraluminal suture technique (fourth-generation bypass) to increase perfusion through antegrade and retrograde flow. OBSERVATIONS The authors present a reimagined S-S STA-M4 bypass in the case of a patient with symptomatic common carotid occlusion, in which the ipsilateral STA filled in a reverse fashion from the contralateral external carotid branches over the scalp vertex (bonnet collaterals). By performing an S-S anastomosis, the authors were able to improve cerebral perfusion and avoid the multiple anastomosis sites of the bonnet bypass. LESSONS The patient had a good recovery with resolution of his preoperative symptoms. Follow-up angiography showed a patent bypass supplying the MCA territory through retrograde flow in the frontal and parietal limbs of the STA, converging at the anastomosis site. In this report, the authors present a new fourth-generation bypass dubbed the “S-S reverse STA-M4 MCA bypass.”

Bilateral common carotid artery occlusion — A case report and literature review

2005 ◽  
Vol 238 (1-2) ◽  
pp. 101-104 ◽  
Author(s):  
Shiao-Lin Lai ◽  
Yi-Chun Chen ◽  
Hsu-Huei Weng ◽  
Sien-Tsong Chen ◽  
Shih-Pin Hsu ◽  
...  
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Literature Review ◽  
Common Carotid Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Bilateral Common Carotid Artery ◽  
Common Carotid Artery Occlusion

Arterial Bypass Surgery Using a Spontaneously Formed “Bonnet” Superficial Temporal Artery in a Patient With Symptomatic Common Carotid Artery Occlusion

2010 ◽  
Vol 67 (3) ◽  
pp. onsE316-onsE317 ◽  
Author(s):  
Kenta Aso ◽  
Kuniaki Ogasawara ◽  
Masakazu Kobayashi ◽  
Kenji Yoshida
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Bypass Surgery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Arterial Bypass ◽  
Arterial Bypass Surgery

Abstract BACKGROUND: Common carotid artery (CCA) occlusive disease may cause hemodynamic cerebral ischemia resulting in the development of ischemic symptoms. The blood flow in the superficial temporal artery (STA) ipsilateral to the occluded CCA is usually poor, which limits its use as a donor artery for extracranial-intracranial arterial bypass surgery. CLINICAL PRESENTATION: Despite antiplatelet therapy, recurrent transient ischemic attacks manifesting as motor aphasia developed in a 72-year-old man. Neuroradiological imaging revealed misery perfusion in the bilateral cerebral hemispheres caused by left CCA occlusion and right internal carotid artery occlusion. Blood flow from the STA contralateral to the occluded CCA perfused the ipsilateral STA over the midline in a retrograde fashion. INTERVENTION: After confirming the direction and the pressure of the blood flow in the spontaneously formed “bonnet” STA, the STA was anastomosed to a cortical artery in the symptomatic frontal lobe so that blood flow in the ipsilateral STA was supplied from the contralateral STA. The procedure was accomplished without difficulty, and no further ischemic symptoms developed after surgery. Postoperative cerebral angiography demonstrated an increase in collateral flow to the anastomosed bonnet STA and perfusion to an entire territory of the upper trunk of the symptomatic middle cerebral artery via the anastomosis. CONCLUSION: This case suggests that arterial bypass surgery can be performed using a spontaneously formed bonnet STA as a donor in a patient with symptomatic CCA occlusion.

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