EC-IC bypass using the distal stump of the superficial temporal artery as an additional collateral source of blood flow in patients with Moyamoya disease
- 78 Downloads
- 3 Citations
Summary
Background. To establish multiple bypass flow in an adult Moyamoya disease patient, the distal stump of the parietal superficial temporal artery (dsPSTA) was used as an additional donor.
Methods. Its potential as the donor was first evaluated by measuring the arterial pressure directly in three patients, revealing about 80% in mean arterial pressure of those measured at the proximal stump and radial artery. The anastomosis was performed just as conventionally except an additional anastomosis between the dsPSTA and frontal branch of the middle cerebral artery in 10 hemispheres of 7 patients.
Results. The patency of the dsPSTA bypass was confirmed on postoperative angiography in 5 patients. The comparison of pre- and post-operative single photon emission computed tomography was feasible in 8 hemispheres of 6 patients of which 7 demonstrated improvement of the cerebral blood flow.
Conclusion. This technique provides a novel source of donor artery in the treatment of Moyamoya disease, in which multiple anastomoses are desirable.
Preview
Unable to display preview. Download preview PDF.
References
- Houkin, K, Ishikawa, T, Yoshimoto, T, Abe, H 1997Direct and indirect revascularization for Moyamoya disease surgical techniques and peri-operative complicationsClin Neurol Neurosurg99142145Google Scholar
- Houkin, K, Kuroda, S, Ishikawa, T, Abe, H 2000Neovascularization (angiogenesis) after revascularization in Moyamoya disease. Which technique is most useful for Moyamoya disease?Acta Neurochir (Wien)142269276CrossRefGoogle Scholar
- Ikeda, A, Yamamoto, I, Sato, O, Morota, N, Tsuji, T, Seguchi, T 1991Revascularization of the calcarine artery in moyamoya disease: OA-cortical PCA anastomosis – case reportNeurol Med Chir31658661Google Scholar
- Iwama, T 2006Surgical treatment for Moyamoya disease: the point and pitfall in practiceNo Shinkei Geka34557564JpnPubMedGoogle Scholar
- Iwama, T, Hashimoto, N, Miyake, H, Yonekawa, Y 1998Direct revascularization to the anterior cerebral artery territory in patients with moyamoya disease: report of five casesNeurosurgery4211571161PubMedCrossRefGoogle Scholar
- Khan, N, Schuknecht, B, Boltshauser, E, Capone, A, Buck, A, Imhof, HG, Yonekawa, Y 2003Moyamoya disease and Moyamoya syndrome: experience in Europe; choice of revascularisation proceduresActa Neurochir (Wien)14510611071CrossRefGoogle Scholar
- Kilinc, H, Bilen, BT 2006A new approach to retroauricular flap transfer: parietal branch-based reverse flow superior auricular artery island flapAnn Plast Surg56380383PubMedCrossRefGoogle Scholar
- Neligan, PC, She-Yue, H, Gullane, PJ 1997Reverse flow as an option in microvascular recipient anastomosesPlast Reconstr Surg10017801785PubMedCrossRefGoogle Scholar
- Reis, CV, Safavi-Abbasi, S, Zabramski, JM, Gusmao, SN, Spetzler, RF, Preul, MC 2006The history of neurosurgical procedures for moyamoya diseaseNeurosurg Focus20E7PubMedCrossRefGoogle Scholar
- Smith, ER, Scott, RM 2005Surgical management of Moyamoya syndromeSkull Base151526PubMedCrossRefGoogle Scholar
- Stock, AL, Collins, HP, Davidson, TM 1980Anatomy of the superficial temporal arteryHead Neck Surg2466469PubMedCrossRefGoogle Scholar
- Takeuchi, S, Kikuchi, H, Karasawa, J, Yamagata, S, Nagata, I 1989Regional cortical blood flow during extra-intracranial bypass surgery in young patients with moyamoya diseaseNeurol Med Chir291014CrossRefGoogle Scholar