Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8691785 | World Neurosurgery | 2018 | 27 Pages |
Abstract
In neurosurgery, extracranial-to-intracranial (EC-IC) bypass surgery is necessary for patients who have undergone surgery in which the superficial temporal artery (STA) was already used for a different bypass procedure or was damaged. Here we report our experience with EC-IC bypass using the occipital artery (OA) in patients in whom the STA was unavailable, and discuss the technical considerations and pitfalls. Five patients with ischemic-onset moyamoya disease and atherosclerotic disease were included. Two patterns of skin incisions were planned according to the OA pathway and recipient artery location. In one of these methods, a skin incision is made above the OA, and a craniotomy is performed under this incision after OA dissection. In the other method, a skin incision is made above the OA to enable its dissection, and a craniotomy is performed via a separate skin incision. No major perioperative complications developed in any of the 5 cases, and bypass patency was confirmed in all patients. There was a significant difference between the preoperative and postoperative asymmetry ratios of the mean transit time values. Our findings suggest that OA-to-middle cerebral artery (MCA) bypass is a simple and effective technique in patients in whom the STA was already used or was damaged by previous intracranial revascularization or craniotomy. This procedure could be an alternative to STA-MCA bypass in patients without an available STA.
Keywords
MCAEC-ICEC-IC bypassCBVMRATIACBFICASTAROI3-dimensionalMTTMagnetic resonance angiographyIschemiaSPECTMoyamoya diseasesingle-photon emission computed tomographycerebral blood flowCerebral blood volumetransient ischemic attackOccipital arterysuperficial temporal arterymiddle cerebral arteryinternal carotid arteryregion of interestMean transit timeAsymmetry ratio
Related Topics
Life Sciences
Neuroscience
Neurology
Authors
Tsukasa Hirano, Takeshi Mikami, Hime Suzuki, Toru Hirano, Yusuke Kimura, Katusya Komatsu, Yukinori Akiyama, Masahiko Wanibuchi, Nobuhiro Mikuni,