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STA-Distal ACA Bypass Using a Contralateral STA Interposition Graft for Symptomatic ACA Stenosis.
Yoon Ha Hwang1, Young Sub Kwon2, Yun Ho Lee2
1Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Journal of Cerebrovascular and Endovascular Neurosurgery
|November 7, 2018
Summary
Superficial temporal artery to anterior cerebral artery bypass surgery can be effective for patients experiencing progressive anterior cerebral artery infarction despite medical treatment. This bypass offers a potential solution for stroke caused by intracranial arterial stenosis.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Surgery
Background:
- Intracranial arterial stenosis, often caused by atherosclerosis, is a leading cause of stroke globally.
- Superficial temporal artery to middle cerebral artery bypass is a recognized procedure for ischemic stroke, though its overall efficacy remains debated.
Observation:
- A 50-year-old male presented with acute left-sided weakness and dysarthria, indicative of a stroke.
- Angiography revealed critical stenosis at the junction of the right internal carotid artery and the right pericallosal artery.
- Despite maximal medical management, the patient experienced fluctuating symptoms and progressive anterior cerebral artery (ACA) infarction on MRI.
Findings:
- A surgical intervention, superficial temporal artery to anterior cerebral artery (STA-ACA) bypass with contralateral STA interposition, was performed.
- The patient's postoperative recovery was uneventful, with no further neurological deterioration observed.
Implications:
- STA-ACA bypass surgery presents a viable treatment option for symptomatic ACA stenosis or occlusion.
- This surgical approach may be particularly beneficial for patients with progressive neurological deficits unresponsive to maximal medical therapy.
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