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Angiographic measurement of the superficial temporal artery for potential use in cerebral bypass surgery: a combined radiological and cadaveric study

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Abstract

Purpose

This study aims to investigate the microsurgical anatomy of the superficial temporal artery (STA), explore the relationship between STA length and lumen diameter, and develop a reliable radiologic method for selecting STA segments for bypass surgery.

Methods

This study used 10 cadaveric dissections (20 STAs, both sides) and 20 retrospective radiological examinations (40 STAs, both sides), employing curved multiplanar reformation and flow color lookup table (CLUT) DICOM processing. Measurements included vessel lumen diameters and luminal cross-sectional thicknesses 3 mm proximal to the STA bifurcation, 3 mm distal to the frontal branch, 5 cm distal to the frontal branch, 3 mm distal to the parietal branch, and 5 cm distal to the parietal branch. The distance between the STA bifurcation and the superior zygomatic border (SZB) was also measured. In our analysis, descriptive statistics encompassed mean, standard deviation (SD), standard error, minimum and maximum values, and distributions. Comparative statistics were performed using Student’s t-test, with statistical significance set at p < 0.05.

Results

There were no statistically significant differences between STA measurements of bifurcation distances (p = 0.88) and lumen diameters (p = 0.46) between cadavers and radiological measures. However, lumen thicknesses were larger in frontal branches than parietal branches at the seventh and eighth centimeter (p = 0.012, p = 0.039). Branches became thinner distally from the zygoma in both cadavers and radiological image measurements.

Conclusion

The CLUT DICOM processing radiological measures provided the high-precision required to enable pre-surgical vessel selection for extracranial-intracranial bypass. The results show that STA vessel luminal diameters are sufficient (> 1 mm) for bypass surgery in the first 9 cm but gradually decrease after that. Also shown is that the choice of frontal versus parietal branches depends on individual anatomical features; therefore, careful preoperative radiological examination is critical.

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Data availability

The data and materials supporting the findings of this study are available upon reasonable request. We are committed to ensuring transparency and reproducibility in our research. For any inquiries regarding the data or materials used in this study, please contact Ayhan Comert, at comertayhan@yahoo.com. We will be pleased to provide detailed information to facilitate further research and validation.

References

  1. Abul-Hassan HS, von Drasek Ascher G, Acland RD (1986) Surgical anatomy and blood supply of the fascial layers of the temporal region. Plast Reconstr Surg 77:17–28

    CAS  PubMed  Google Scholar 

  2. Balik V, Kourilova P, Sulla IJ et al (2020) Comparison of bypass and non–bypass surgical treatments for internal carotid artery blood blister-like aneurysms: a meta-analysis of efficacy, safety, and outcomes. World Neurosurg 144:283–292

    Article  PubMed  Google Scholar 

  3. Chen T-H, Chen C-H, Shyu J-F et al (1999) Distribution of the superficial temporal artery in the Chinese adult. Plast Reconstr Surg 104:1276–1279

    Article  CAS  PubMed  Google Scholar 

  4. Czerwiński F (1992) Variability in the course of the superficial temporal artery in man. Folia Morphol (Warsz) 51:49–54

    PubMed  Google Scholar 

  5. Guler TM, Comert A, Gungor Y et al (2022) Topographical anatomy of the superficial temporal artery. Turk Neurosurg

  6. Horiuchi T, Nitta J, Ishizaka S et al (2013) Emergency EC-IC bypass for symptomatic atherosclerotic ischemic stroke. Neurosurg Rev 36:559–565

    Article  PubMed  Google Scholar 

  7. Jean-Philippe H, Benoît B, Françoise K, Michael D (2021) Anatomy and external landmarks of the superficial temporal artery using 3-dimensional computed tomography. Surg Radiol Anat 43:283–290

    Article  PubMed  Google Scholar 

  8. Kim BS, Jung YJ, Chang CH, Choi BY (2013) The anatomy of the superficial temporal artery in adult koreans using 3-dimensional computed tomographic angiogram: clinical research. J Cerebrovasc Endovasc Neurosurg 15:145–151

    Article  PubMed  PubMed Central  Google Scholar 

  9. Koziej M, Trybus M, Hołda M et al (2019) The superficial temporal artery: anatomical map for facial reconstruction and aesthetic procedures. Aesthet Surg J 39:815–823

    Article  PubMed  Google Scholar 

  10. Marano SR, Fischer DW, Gaines C, Sonntag VKH (1985) Anatomical study of the superficial temporal artery. Neurosurgery 16:786–790

    Article  CAS  PubMed  Google Scholar 

  11. Mathkour M, Werner C, Scullen T et al (2022) Detethering the superficial temporal artery: application to tension free superficial temporal artery-middle cerebral artery bypasses. Clin Anat 35:428–433

    Article  PubMed  Google Scholar 

  12. Matsuo S, Komune N, Akiyama O et al (2020) Surgical anatomy of the donor arteries for extracranial-intracranial bypass surgery: an anatomic and radiologic study. World Neurosurg 136:e447–e459

    Article  PubMed  Google Scholar 

  13. Mwachaka P, Sinkeet S, Ogeng’o J (2010) Superficial temporal artery among kenyans: pattern of branching and its relation to pericranial structures. Folia Morphol (Warsz) 69:51–53

    CAS  PubMed  Google Scholar 

  14. Pinar YA, Govsa F (2006) Anatomy of the superficial temporal artery and its branches: its importance for surgery. Surg Radiol Anat 28:248–253

    Article  PubMed  Google Scholar 

  15. Rusu MC, Jianu AM, Rădoi PM (2021) Anatomic variations of the superficial temporal artery. Surg Radiol Anat 43:445–450

    Article  PubMed  Google Scholar 

  16. Sahinoglu K, Koldas T, Gorgun B et al (1994) Arteria temporalis superficialis ve arteria temporalis media anatomisi. Istanbul Med J 57:40–42

    Google Scholar 

  17. Stock AL, Collins HP, Davidson TM (1980) Anatomy of the superficial temporal artery. Head Neck Surg 2:466–469

    Article  CAS  PubMed  Google Scholar 

  18. Strauch B, Yu H-L, Chen Z-W et al (1995) Atlas of microvascular surgery: anatomy and operative approaches. Plast Reconstr Surg 95:765

    Google Scholar 

  19. Tayfur V, Edizer M, Magden O (2010) Anatomic bases of superficial temporal artery and temporal branch of facial nerve. J Craniofac Surg 21:1945–1947

    Article  PubMed  Google Scholar 

Download references

Funding

We confirm that this research received no specific funding or financial support from any public, private, or commercial organization. All expenses related to this study were self-funded by the authors. The authors have no financial interests or affiliations that could have influenced the outcomes or conclusions presented in this manuscript.

Author information

Authors and Affiliations

  1. Etlik City Hospital, Department of Neurosurgery, Ankara, Turkey

    Omer S. Sahin

  2. School of Medicine, Department of Neurosurgery, Hacettepe University, Ankara, Turkey

    Sahin Hanalioglu

  3. Diskapi Yildirim Beyazit Research and Education Hospital, Department of Neurosurgery, Ankara, Turkey

    Ahmet Metin Sanli

  4. Dr. Abdurrahman Yurtaslan Oncology Research and Education Hospital, Department of Neurosurgery, Ankara, Turkey

    Abdurrahman Bakir

  5. School of Medicine, Department of Anatomy, Ankara University, Sihhiye, Ankara, 06100, Turkey

    Ayhan Comert

  6. Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Mustafa K. Baskaya

Authors
  1. Omer S. Sahin
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  2. Sahin Hanalioglu
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  3. Ahmet Metin Sanli
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  4. Abdurrahman Bakir
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  5. Ayhan Comert
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Contributions

OS Sahin: Project development, Data collection, Manuscript writing. S Hanalioglu: Data analysis. AM Sanli: Protocol development. A Bakir: Data management. A Comert: Data collection, Manuscript editing. MK Baskaya: Manuscript editing. All authors have contributed significantly, and that all authors are in agreement with the manuscript. All authors reviewed the manuscript.

The authors thank Steven L. Goodman, Ph.D. for his editing and technical review of this work.

Corresponding author

Correspondence to Ayhan Comert.

Ethics declarations

Ethical approval

This study was performed according to ethical guidelines for research and publication. Ethics committee approval was obtained from the Clinical Research Ethics Committee of the University of Health Sciences Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital (Decision 66/12) for radiological analysis. Ethical approval was not required for the cadaveric study. All cadavers were supplied from a donated institution with subjects giving written informed consent for the use of samples in scientifc studies. All the performed procedures in this study that involve cadavers followed the ethical standards of the Institutional Review Board and the 1964 Helsinki declaration and its later amendments or comparable ethical standards The authors sincerely thank those who donated their bodies to science that enabled this anatomical research. Results from such research can potentially increase humanity’s overall knowledge, which can then improve patient care. Therefore, these donors and their families deserve our highest gratitude.

Competing interests

The authors declare no competing interests.

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Sahin, O.S., Hanalioglu, S., Metin Sanli, A. et al. Angiographic measurement of the superficial temporal artery for potential use in cerebral bypass surgery: a combined radiological and cadaveric study. Surg Radiol Anat 46, 605–614 (2024). https://doi.org/10.1007/s00276-024-03325-w

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  • DOI: https://doi.org/10.1007/s00276-024-03325-w

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