Superficial Temporal Artery to Middle Cerebral Artery Double Bypass Via a Small Craniotomy -Technical Note-

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  • YOSHIMURA Shinichi
    Department of Neurosurgery, Graduate School of Medicine, Gifu University
  • EGASHIRA Yusuke
    Department of Neurosurgery, Graduate School of Medicine, Gifu University
  • ENOMOTO Yukiko
    Department of Neurosurgery, Graduate School of Medicine, Gifu University
  • YAMADA Kiyofumi
    Department of Neurosurgery, Graduate School of Medicine, Gifu University
  • YANO Hirohito
    Department of Neurosurgery, Graduate School of Medicine, Gifu University
  • IWAMA Toru
    Department of Neurosurgery, Graduate School of Medicine, Gifu University

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Frontotemporal craniotomy is usually necessary to perform superficial temporal artery (STA)-middle cerebral artery (MCA) double bypass for cerebrovascular occlusive disease. This report describes a less invasive technique of double bypass through a small craniotomy with minimum skin incision. Thirty-four consecutive patients underwent an elective STA-MCA double bypass via a small craniotomy from January 2006 to October 2009. The parietal and frontal branches of the STA were divided through a minimum linear or y-shaped skin incision, and these branches were anastomosed to the supra- and infrasylvian portions of the MCA. No periprocedural complication such as subdural hematoma or cutaneous necrosis occurred. Postoperative cerebral angiography within 6 months showed that the bypasses were patent in all 34 patients. Double STA-MCA bypass via a small craniotomy might be less invasive, especially for patients at high risk for postoperative hemorrhagic complication or cutaneous necrosis.<br>

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