scholarly journals Superficial Temporal Artery to Middle Cerebral Artery Bypass and External Carotid Reconstruction for Carotid Restenosis After Angioplasty and Stent Placement

2000 ◽  
Vol 75 (10) ◽  
pp. 1087-1090 ◽  
Author(s):  
Wouter I. Schievink ◽  
Reid C. Thompson ◽  
Sean D. Lavine ◽  
John S. Yu
2019 ◽  
Vol 18 (5) ◽  
pp. 480-486 ◽  
Author(s):  
Michael J Lang ◽  
Peter Kan ◽  
Jacob F Baranoski ◽  
Michael T Lawton

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.


Author(s):  
Gustavo Rassier Isolan ◽  
Ricardo de Andrade Caracante ◽  
João Paulo Mota Telles ◽  
Nícollas Nunes Rabelo ◽  
Eberval Gadelha Figueredo

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.


2021 ◽  
Author(s):  
Nickalus R Khan ◽  
Jacques J Morcos

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.


Neurosurgery ◽  
1983 ◽  
Vol 12 (3) ◽  
pp. 342-345 ◽  
Author(s):  
Frances K. Conley

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.


2019 ◽  
Vol 47 (4) ◽  
pp. 290-295
Author(s):  
Ryo SUZUKI ◽  
Isao KITAHARA ◽  
Ataru FUKUDA ◽  
Hiroshi YONETANI ◽  
Tomoki YOKOCHI ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document