BACKGROUND Superficial temporal artery-middle cerebral artery(STA-MCA)bypass helps treat cerebral ischemia.However,the STA is not available for bypass in some conditions.Therefore,with some technical tips,the authors ...BACKGROUND Superficial temporal artery-middle cerebral artery(STA-MCA)bypass helps treat cerebral ischemia.However,the STA is not available for bypass in some conditions.Therefore,with some technical tips,the authors introduced a bypass technique using the occipital artery(OA).CASE SUMMARY Two female patients complained of hemiparesis.Brain magnetic resonance imaging(MRI)indicated contralateral infarction from the MCA steno-occlusion.On Diamox single photon emission computed tomography or perfusion MRI,the contralateral front parietotemporal reserve was diminished.On transfemoral cerebral angiography,the STA was thin with a weak flow;however,the OA was prominent.Direct OA-MCA end-to-side extracranial-intracranial bypass surgery was implemented instead of STA because the caliber was too narrow.The postoperative course was uneventful in both cases,with well-maintained bypass patency and neurological stability during follow-up.CONCLUSION OA might be an acceptable alternative for MCA cerebral ischemic cases with an unsuitable STA.展开更多
基金Supported by a grant from Chonnam National University Hospital Biomedical Research Institute,No.BCRI22053.
文摘BACKGROUND Superficial temporal artery-middle cerebral artery(STA-MCA)bypass helps treat cerebral ischemia.However,the STA is not available for bypass in some conditions.Therefore,with some technical tips,the authors introduced a bypass technique using the occipital artery(OA).CASE SUMMARY Two female patients complained of hemiparesis.Brain magnetic resonance imaging(MRI)indicated contralateral infarction from the MCA steno-occlusion.On Diamox single photon emission computed tomography or perfusion MRI,the contralateral front parietotemporal reserve was diminished.On transfemoral cerebral angiography,the STA was thin with a weak flow;however,the OA was prominent.Direct OA-MCA end-to-side extracranial-intracranial bypass surgery was implemented instead of STA because the caliber was too narrow.The postoperative course was uneventful in both cases,with well-maintained bypass patency and neurological stability during follow-up.CONCLUSION OA might be an acceptable alternative for MCA cerebral ischemic cases with an unsuitable STA.
