Radial artery graft for bypass of the maxillary to proximal posterior cerebral artery: An anatomical and technical study

Ülkü, Çağatay Han; Üstün, Mehmet Erkan; Büyükmumcu, Mustafa; Çiçekcibaşı, Aynur Emine; Ziylan, Taner

doi:10.1080/00016480410017477

Cited by 30 publications

(9 citation statements)

References 11 publications

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“…[8][9][10] Therefore, the scholars began to study anatomy of the maxillary artery and tried to perform the vascular bypass of the MA and the proximal middle cerebral artery. [4][5][6] Currently, there have been few clinical reports about the bypass through the MA to treat ischemic cerebral diseases and giant aneurysms. 6 In this research, we discovered that the diameters of the maxillary artery, the radial artery, and M2 part of cerebral middle artery matched with each other.…”

Section: Discussionmentioning

confidence: 99%

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Bypass of the Maxillary Artery to Proximal Middle Cerebral Artery

Ren

Huang

2015

Journal of Craniofacial Surgery

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Section: Discussionmentioning

confidence: 99%

“…Recently, many scholars have been trying to study a new bypass method that can produce higher blood flow, shorter grafting blood vessels through bypass of the maxillary artery (MA) with intracranial artery. [4][5][6] This study was aimed to prove the feasibility of bypass between MA and proximal high blood flow vessels of middle cerebral artery.…”

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confidence: 99%

Bypass of the Maxillary Artery to Proximal Middle Cerebral Artery

Ren

Huang

2015

Journal of Craniofacial Surgery

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“…Imax-MCA (SC-IC) bypass as a high-flow EC-IC bypass option has been described in both cadaveric studies6-9,17 and clinical microsurgical practice 5. This bypass option is efficacious in cases that require high flow where the use of the cervical carotid as a donor is contraindicated (ie, after neck surgery or in the setting of occlusion of the common carotid artery).…”

Section: Discussionmentioning

confidence: 99%

Internal Maxillary Artery-Middle Cerebral Artery Bypass

et al. 2014

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BACKGROUND:Internal maxillary artery (IMax)–middle cerebral artery (MCA) bypass has been recently described as an alternative to cervical extracranial-intracranial bypass. This technique uses a “keyhole” craniectomy in the temporal fossa that requires a technically challenging end-to-side anastomosis.OBJECTIVE:To describe a lateral subtemporal craniectomy of the middle cranial fossa floor to facilitate wide exposure of the IMax to facilitate bypass.METHODS:Orbitozygomatic osteotomy is used followed by frontotemporal craniotomy and subsequently laterotemporal fossa craniectomy, reaching its medial border at a virtual line connecting the foramen rotundum and foramen ovale. The IMax was identified by using established anatomic landmarks, neuronavigation, and micro Doppler probe (Mizuho Inc. Tokyo, Japan). Additionally, we studied the approach in a cadaveric specimen in preparation for microsurgical bypass.RESULTS:There were 4 cases in which the technique was used. One bypass was performed for flow augmentation in a hypoperfused hemisphere. The other 3 were performed as part of treatment paradigms for giant middle cerebral artery aneurysms. Vein grafts were used in all patients. The proximal anastomosis was performed in an end-to-side fashion in 1 patient and end-to-end in 3 patients. Intraoperative graft flow measured with the Transonic flow probe ranged from 20 to 60 mL/min. Postoperative angiography demonstrated good filling of the graft with robust distal flow in all cases. All patients tolerated the procedure well.CONCLUSION:IMax to middle cerebral artery subcranial-intracranial bypass is safe and efficacious. The laterotemporal fossa craniectomy technique resulted in reliable identification and wide exposure of the IMax, facilitating the proximal anastomosis.ABBREVIATIONS:EC-IC, extracranial-intracranialIMax, internal maxillary arteryMCA, middle cerebral arterySC-IC, subcranial-intracranialSTA, superficial temporal artery

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“…These largerdiameter conduits (2.5-3.7 mm, respectively) are suitable for flow replacement in diseases in which the vessel must be sacrificed. 19,20 Each vascular conduit has benefits and drawbacks depending on the goals of surgery. The STA and OA provide flow augmentation and, in general, do not serve flow replacement for the carotid artery distribution.…”

Section: Discussionmentioning

confidence: 99%

Alternative vascular graft for extracranial–intracranial bypass surgery: descending branch of the lateral circumflex femoral artery

Başkaya¹,

Kiehn

Ahmed³

et al. 2008

FOC

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Object Arterial bypass is an important method of treating intracranial disease requiring sacrifice of the parent vessel. The conduits for extracranial–intracranial (EC–IC) bypass surgery include the superficial temporal artery, occipital artery, superior thyroid artery, radial artery, and saphenous vein (long or short). In an aging population with an increased prevalence of vascular disease, conduits for EC–IC bypass may be in short supply in some patients. Herein, the authors describe a case in which the descending branch of the lateral circumflex femoral artery (DLCFA) was utilized as a high-flow conduit for an EC–IC bypass. Methods This 22-year-old woman presented with irregular menstrual periods, secondary amenorrhea, and hypothyroidism. A giant intrasellar and suprasellar mass was found. Angiography confirmed a 3.5 × 2.1–cm fusiform aneurysm involving the cavernous and supraclinoid segments of the right internal carotid artery. A suitable radial artery conduit was not available. The DLCFA was harvested and anastomosed between the M2 segment of the middle cerebral artery and the external carotid artery. Results Durable clinical and angiographic results were apparent at the 2-month follow-up. Conclusions The DLCFA's diameter and length were used successfully in a high-flow EC–IC bypass surgery. The DLCFA may be a good alternative to radial artery and saphenous vein grafts for an EC–IC bypass requiring high flow.

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Radial artery graft for bypass of the maxillary to proximal posterior cerebral artery: An anatomical and technical study

Abstract: As MA to proximal PCA bypass uses a short radial graft and as the calibers of the MA and PCA are >2 mm such a bypass may provide sufficient blood flow and represents a reasonable alternative to "ECA to PCA" bypass.

Cited by 30 publications

References 11 publications

Bypass of the Maxillary Artery to Proximal Middle Cerebral Artery

Bypass of the Maxillary Artery to Proximal Middle Cerebral Artery

Internal Maxillary Artery-Middle Cerebral Artery Bypass

Alternative vascular graft for extracranial–intracranial bypass surgery: descending branch of the lateral circumflex femoral artery

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