Document Detail

"Bonnet" bypass to proximal trunk of middle cerebral artery with a radial artery interposition graft: technical note.
MedLine Citation:
PMID:  21132614     Owner:  NLM     Status:  In-Process    
BACKGROUND: Anastomosis of the superficial temporal artery (STA) to the middle cerebral artery (MCA) is useful for treating certain patients with internal carotid artery occlusion or MCA occlusion. However, in the case of common carotid artery (CCA) occlusion, since the blood flow in the STA is insufficient, another artery should be used as the donor artery. The cortical branches of the MCA are usually selected as recipients in the STA-MCA bypass. However, the intracranial vascular filling gradually increases over a few months after conventional cortical MCA bypass grafting, while early or even immediate vascular filling is observed after proximal MCA bypass grafting. This study aims to develop an elongation technique of the contralateral STA to reach the proximal segment of the ipsilateral MCA.
METHODS: Anastomosis of the contralateral STA to the secondary trunk of the ipsilateral MCA was performed in 2 patients with occlusion of the CCA and ipsilateral vertebral artery (VA). The contralateral STA was extended with a radial artery (RA) graft in order to supply blood to the ischemic area. Elongation of the STA by using an RA interposition graft sufficiently lengthens the graft to enable its anastomosis with the contralateral M2 segment. Postoperative imaging revealed good bypass patency even at 1 year after the surgery.
CONCLUSION: This novel technique of performing the "bonnet" bypass was effective in treating both CCA and ipsilateral VA occlusion; moreover, this procedure of elongation of the STA can increase candidates of the recipient, and enables one to perform a double bypass to the anterior cerebral artery (ACA) or posterior cerebral artery (PCA).
Y Sanada; H Kamiyama; K Iwaisako; T Yoshimine; A Kato
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Publication Detail:
Type:  Journal Article     Date:  2010-12-03
Journal Detail:
Title:  Minimally invasive neurosurgery : MIN     Volume:  53     ISSN:  1439-2291     ISO Abbreviation:  Minim Invasive Neurosurg     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-12-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440973     Medline TA:  Minim Invasive Neurosurg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  203-6     Citation Subset:  IM    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
Department of Neurosurgery, Kinki University Medical School, 377-2 Ohno-Higashi, Osaka-Sayama, Japan.
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