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Updated: Aug 4, 2025

Optimization of the Longa Middle Cerebral Artery Occlusion Method for Complete Reperfusion
Published on: November 22, 2024
Occipital artery bypass importance in unsuitable superficial temporal artery: Two case reports
Jong-Hwan Hong1, Sung-Chan Jung1, Han-Seung Ryu1
1Department of Neurosurgery, Chonnam National University Hospital and Medical School, Gwangju 61469, South Korea.
Background:
Superficial temporal artery-middle cerebral artery (STA-MCA) bypass helps treat cerebral ischemia. However, the STA is not available for bypass in some conditions. Therefore, with some technical tips, the authors introduced a bypass technique using the occipital artery (OA).
Case Summary:
Two female patients complained of hemiparesis. Brain magnetic resonance imaging (MRI) indicated contralateral infarction from the MCA steno-occlusion. On Diamox single photon emission computed tomography or perfusion MRI, the contralateral front parietotemporal reserve was diminished. On transfemoral cerebral angiography, the STA was thin with a weak flow; however, the OA was prominent. Direct OA-MCA end-to-side extracranial-intracranial bypass surgery was implemented instead of STA because the caliber was too narrow. The postoperative course was uneventful in both cases, with well-maintained bypass patency and neurological stability during follow-up.
Conclusion:
OA might be an acceptable alternative for MCA cerebral ischemic cases with an unsuitable STA.
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