| The Efficacy of Superficial Temporal Artery-Middle Cerebral Artery Bypass in Treatment of Athero-occlusive Cerebrovascular Disease |
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Byung-Chul Kim , In-Ho Han , Won-Ho Cho , Byung-Kwan Choi , Seung-Heon Cha , Chang-Hwa Choi , Jun-Kyeung Ko |
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Department of Neurosurgery, Medical Research Institute, Pusan National University College of Medicine, Busan, Korea |
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| Abstract |
Objective
In this retrospective study, we wanted to examine the potential role of superficial temporal artery (STA)- middle cerebral artery (MCA) bypass in patients with symptomatic hemodynamic impairment secondary to athero-occlusive disease.
Methods
A retrospective review identified 30 patients who underwent 32 STA-MCA bypass procedures performed for treatment of athero-occlusive cerebrovascular disease between 2005 and 2011. All patients were refractory to medical treatment and had symptomatic hemodynamic impairment pre-operatively. A total of 28 patients who underwent 30 bypass procedures were followed up over an average period of 33 months (range, 11-89 months).
Results
Angiographic findings included unilateral internal carotid artery (ICA) stenosis or occlusion in 14 patients, bilateral ICA stenosis or occlusion in three patients, unilateral MCA stenosis or occlusion in nine patients, bilateral MCA occlusion in one patient and other multiple vessel stenosis or occlusion in three patients. There was no occurrence of peri-operative mortality, and peri-operative morbidity was only 3%. During the follow-up period, 25 patients (89%) had no further cerebrovascular events. Ipsilateral minor stroke occurred in two patients (7%) and ipsilateral major stroke occurred in one patient (3%). Improved cerebral hemodynamics was documented in 17 (77%) of 22 revascularized hemispheres. Post-operative bypass patency was clearly verified in 20 (77%) of 26 bypasses.
Conclusion
Although bypass surgery for treatment of athero-occlusive cerebrovascular disease is still controversial, results of our retrospective study suggest both an improvement of cerebral hemodynamics and a risk-reduction for future cerebrovascular events after surgery. |
| Key Words:
Carotid artery stenosisㆍCerebral atherosclerosisㆍStrokeㆍSTA-MCA bypass |
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