Computed tomographic angiography in evaluation of superficial temporal to middle cerebral artery bypass

Catheter-directed digital subtraction angiography (DSA) is considered the standard for evaluation of superficial temporal to middle cerebral artery (STA-MCA) bypass patency. Few clinical investigations have been performed that evaluate the efficacy of computed tomographic angiography (CTA) in the assessment of extracranial-intracranial bypass. Using multi-detector row CTA, STA-MCA bypass patency was assessed in the initial postoperative period and several months afterward and compared with DSA. No significant difference was identified in the evaluation of graft patency between DSA and CTA. Although multiple modalities exist to evaluate STA-MCA bypass graft patency, the multidetector CTA is widely available and allows for rapid, accurate patency assessment.