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STA-MCA/STA-PCA Bypass Using Short Interposition Vein Graft.

Yasuhiko Kaku1, Naoko Funatsu, Masanori Tsujimoto

  • 1Department of Neurosurgery, Asahi University Murakami Memorial Hospital, Hashimoto-cho 3-23, Gifu, 500-8523, Japan, kaku@murakami.asahi-u.ac.jp.

Acta Neurochirurgica. Supplement
|April 15, 2014
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Summary

Using the superficial temporal artery (STA) main trunk with a vein graft offers adequate blood flow for cerebral revascularization. This EC-IC bypass alternative provides a viable option for complex aneurysms and occlusions.

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Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Cerebrovascular Surgery

Background:

  • The superficial temporal artery (STA) is commonly used for extra-intracranial (EC-IC) bypass in cerebral revascularization.
  • Standard STA branches may lack sufficient flow capacity for certain neurosurgical applications.
  • An alternative approach using the STA main trunk with a vein interposition graft is explored.

Purpose of the Study:

  • To evaluate the efficacy and flow capacity of using the STA main trunk as a donor vessel for EC-IC bypass.
  • To assess the feasibility of this technique in treating complex cerebrovascular conditions.

Main Methods:

  • Seven patients underwent EC-IC bypass utilizing the STA main trunk and a short vein interposition graft.
  • Grafts were anastomosed to the M2 segment of the middle cerebral artery (MCA) or the P2/3 or P3 segments of the posterior cerebral artery (PCA).
  • Indications included treatment of aneurysms and internal carotid artery occlusion.

Main Results:

  • All bypasses remained patent postoperatively.
  • Intraoperative flow measurements demonstrated a moderate flow capacity of 20-50 ml/min (mean 43 ml/min) for the STA main trunk grafts.
  • The STA main trunk, with its larger diameter, is expected to have higher flow capacity than its distal branches.

Conclusions:

  • STA main trunk to MCA/PCA bypass using short vein grafts provides sufficient blood flow.
  • This technique represents a reasonable alternative to external carotid artery (ECA) to MCA/PCA bypass with long vein grafts.
  • It offers a valuable option for cerebral revascularization in specific neurosurgical cases.