Superficial temporal artery to middle cerebral artery double bypass via a small craniotomy: technical note.
Neurol Med Chir (Tokyo). 2010;50(10):956-9
Authors: Yoshimura S, Egashira Y, Enomoto Y, Yamada K, Yano H, Iwama T
Frontotemporal craniotomy is usually necessary to perform superficial temporal artery (STA)-middle cerebral artery (MCA) double bypass for cerebrovascular occlusive disease. This report describes a less invasive technique of double bypass through a small craniotomy with minimum skin incision. Thirty-four consecutive patients underwent an elective STA-MCA double bypass via a small craniotomy from January 2006 to October 2009. The parietal and frontal branches of the STA were divided through a minimum linear or y-shaped skin incision, and these branches were anastomosed to the supra- and infrasylvian portions of the MCA. No periprocedural complication such as subdural hematoma or cutaneous necrosis occurred. Postoperative cerebral angiography within 6 months showed that the bypasses were patent in all 34 patients. Double STA-MCA bypass via a small craniotomy might be less invasive, especially for patients at high risk for postoperative hemorrhagic complication or cutaneous necrosis.
PMID: 21030817 [PubMed - in process]