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Endoscopically assisted harvesting of the superficial temporal artery: technical note
Shigeki Kubo1, Hiroshi Takimoto, Toshiki Yoshimine
1Department of Neurosurgery, Osaka Neurological Institute, Takara-machi, Toyonaka, Japan. sig-kubo@momo.so-net.ne.jp
Objective:
We developed an endoscopic method for harvesting the superficial temporal artery (STA) through a small incision away from the artery. This method was used to harvest the frontal branch of the STA through an incision made along the parietal branch.
Methods:
A 7-cm linear incision is made along the parietal branch of the STA. After the parietal branch has been exposed, the frontal branch is accessed through the incision with the use of an optical retractor and a 4-mm endoscope. The frontal branch is harvested subcutaneously, under endoscopic observation. Both branches of the STA are anastomosed to the middle cerebral artery via a small craniotomy made through the incision. This method was used for six patients who presented with ischemic symptoms attributable to hypoperfusion in the middle cerebral artery area.
Results:
The frontal branch of the STA, measuring 6 to 8 cm, was harvested subcutaneously. The procedure required 30 to 60 minutes. The patency of the artery was verified with postoperative angiography. Hair loss or scalp necrosis was not noted for any patient.
Conclusion:
Our experience demonstrates that the STA can be harvested through a small incision distant from the artery. Postoperative scalp necrosis and hair loss can be avoided. This less-invasive method expands the use of the STA in revascularization surgery beyond the limitations imposed by its anatomic course.