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Signal reduction of donor artery on MRI after superficial temporal artery to middle cerebral artery anastomosis: a retrospective analysis

  • Original Article - Vascular
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Abstract

Object

Microsurgical anastomosis from the superficial temporal artery (STA) to the middle cerebral artery (MCA) is a treatment option for appropriately selected patients with cranial atherosclerotic steno-occlusive disease (CASD). However, the long-term efficacy and patency of the donor artery remain unclear. We reviewed the signal intensity of the donor artery on magnetic resonance angiography (MRA) after STA-MCA anastomosis in patients with CASD and clarified the incidence of and risk factors for reduction in postoperative signal of STA.

Methods

From April 2007 to March 2015, 155 STA-MCA anastomosis operations for CASD were performed at our institute. The postoperative imaging findings of 112 patients with available follow-up data for more than 3 months were retrospectively reviewed.

Results

Over a median follow-up of 24 months, the signal of the donor artery on MRA became weaker than that on MRA performed immediately after surgery in 30 (27%) patients. The rates of signal reduction at 1 and 2 years after surgery were 18 and 25%, respectively. Multivariate analysis revealed that a high STA bifurcation (p = 0.015; odds ratio, 7.14) and the presence of chronic kidney disease (p = 0.011; odds ratio, 5.59) were independent risk factors for postoperative signal reduction.

Conclusions

Our results suggest that the signal intensity of the donor artery of an established STA-MCA bypass decreases in many cases. Both the loose entrance of the STA to the dura and systemic atherosclerosis are related to postoperative vessel remodeling.

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Authors and Affiliations

  1. Department of Neurosurgery, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan

    Satoshi Koizumi, Toshikazu Kimura & Tomohiro Inoue

  2. Department of Neurosurgery, The University of Tokyo, Tokyo, Japan

    Satoshi Koizumi

Authors
  1. Satoshi Koizumi
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  2. Toshikazu Kimura
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  3. Tomohiro Inoue
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Correspondence to Toshikazu Kimura.

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Comments

This manuscript examines the patency of the superficial temporal artery to the middle cerebral artery (STA-MCA) bypass performed in patients with cranial atherosclerotic steno-occlusive disease (CASD) using magnetic resonance angiography (MRA). The authors also examine the technical and clinical risk factors associated with bypass occlusion over time, and so it is an original work that adds to the literature. Interestingly, our group previously quantified STA-MCA bypass flows over time in CASD patients and found similar results: S Amin-Hanjani et al. Evaluation of extracranial-intracranial bypass using quantitative magnetic resonance angiography. J Neurosurg 2007;106:291–298.

Fady T. Charbel, Sophia F. Shakur

Chicago, IL, USA

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Koizumi, S., Kimura, T. & Inoue, T. Signal reduction of donor artery on MRI after superficial temporal artery to middle cerebral artery anastomosis: a retrospective analysis. Acta Neurochir 159, 1679–1685 (2017). https://doi.org/10.1007/s00701-017-3128-x

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  • DOI: https://doi.org/10.1007/s00701-017-3128-x

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