Short Segment Internal Maxillary Artery to Middle Cerebral Artery Bypass: A Novel Technique for Extracranial-to-Intracranial Bypass

Abdulrauf, Saleem I.; Sweeney, Justin M.; Mohan, Yedathore S.; Palejwala, Sheri K.

doi:10.1055/s-2011-1274210

Cited by 8 publications

(18 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The infratemporal craniectomy (Nossek et al, 2014) was extended to reach a point 2 mm lateral to the line between the foramen ovale and foramen rotundum to expose the MA between the infratemporal and sphenopalatine fossae to provide a satisfactory length of MA for the EC-IC bypass (Figs. 1A and 1B;Abdulrauf et al, 2011;Nossek et al, 2014). The drilling in the anterolateral wall of the middle fossa started at the greater wing of the sphenoid bone and continued medially and inferiorly to the infratemporal crest.…”

Section: Methodsmentioning

confidence: 99%

“…Then, Vrionis et al (1996) and Ulku et al (2004) reported the high-flow EC-IC bypass using the MA as the donor artery. Abdulrauf et al (2011) described the first case of MA to MCA bypass with a RA graft for a giant cavernous paraclinoid carotid aneurysm. Exposure of the MA for bypass is considered difficult although its exposure in the middle cranial fossa has been reported.…”

Section: Fig 5 Amentioning

confidence: 99%

“…Advantages compared with the external carotid artery bypass include shorter graft, increased graft patency, and no redundant neck incision and subcutaneous tunnel. The technique of exposing the MA through the middle cranial fossa has previously been described using the anterolateral and infratemporal approaches (Abdulrauf et al, ; Nossek et al, ). These approaches expose the MA between the infratemporal and sphenopalatine fossae.…”

Section: Introductionmentioning

confidence: 99%

“…Advantages compared with the external carotid Abbreviations: ADTA, anterior deep temporal artery; CTA, computed tomography angiography; EC-IC, extracranialintracranial; ECA, external carotid artery; ICA, internal carotid artery; IOA, infraorbital artery; MA, maxillary Artery; MCA, middle cerebral artery; PSAA, posterior superior alveolar artery; RA, radial artery artery bypass include shorter graft, increased graft patency, and no redundant neck incision and subcutaneous tunnel. The technique of exposing the MA through the middle cranial fossa has previously been described using the anterolateral and infratemporal approaches (Abdulrauf et al, 2011;Nossek et al, 2014). These approaches expose the MA between the infratemporal and sphenopalatine fossae.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Microsurgical anatomy of the maxillary artery for extracranial‐intracranial bypass in the pterygopalatine segment of the maxillary artery

et al. 2017

View full text Add to dashboard Cite

The extracranial-intracranial (EC-IC) bypass using the maxillary artery (MA) has been successfully completed using a radial artery (RA) graft but the complicated anatomy and narrow exposure make it difficult. The purpose of this article is to define the microsurgical exposure of the MA through the middle fossa and describe the branches, diameter, and length of the MA available for the EC-IC bypass in the sphenopalatine fossa and anterior part of the infratemporal fossa. 5 cadaveric specimens were dissected bilaterally (10 MA dissections) to define the microsurgical anatomy of the MA through an intracranial approach. The exposable branches of the MA at the level of the infratemporal and sphenopalatine fossae were the anterior deep temporal, posterior superior alveolar, and infraorbital arteries. The origin of each branch could be exposed. The available section of the MA for use as a donor vessel is between the origin of the anterior deep temporal artery and the infraorbital artery. The mean exposable length of the MA was 19.4 mm. The mean outer diameter of the donor MA was 3.2 mm. Tension-free EC-IC bypass was possible using a RA graft between the MA and the middle cerebral artery, the MA and the supraclinoid internal carotid artery (ICA), or the MA and the petrous ICA. Exposure of the MA at the infratemporal and sphenopalatine fossae is complicated but provides length and diameter suitable as a donor artery for the EC-IC bypass. Clin. Anat. 31:724-733, 2018. © 2017 Wiley Periodicals, Inc.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Fig 5 Amentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Microsurgical anatomy of the maxillary artery for extracranial‐intracranial bypass in the pterygopalatine segment of the maxillary artery

et al. 2017

View full text Add to dashboard Cite

show abstract

“…21,22 A drawback is the more difficult exposure and technically challenging anastomosis to the IMAX.…”

Section: Surgical Anatomy Pearlmentioning

confidence: 99%

25 Skull Base Approaches in Cerebrovascular Surgery

Ieva¹,

Lee²,

Cusimano³

2016

Handbook of Skull Base Surgery

View full text Add to dashboard Cite

Localization of the Internal Maxillary Artery for Extracranial-to-Intracranial Bypass through the Middle Cranial Fossa: A Cadaveric Study

et al. 2012

Self Cite

View full text Add to dashboard Cite

The internal maxillary artery (IMAX) is a promising arterial pedicle to function as a donor vessel for extracranial-to-intracranial (EC-IC) bypass procedures. The access to the IMAX through the anterior portion of the middle cranial fossa floor allows a much shorter interposition graft to be used to create a bypass to the ipsilateral middle cerebral artery and prevents a second incision in the neck. One of the challenges of this technique, however, is the difficulty to find the IMAX through an intracranial approach. The purpose of this cadaveric study is to establish a reliable method to localize the IMAX through a middle fossa floor approach based on skull base bone landmarks. In this study 5 latexinjected fixated cadaveric specimens were dissected bilaterally (providing a total of 10 IMAX dissections) to determine the precise location of the IMAX in the pterygopalatine fossa in relationship to bone landmarks of the middle fossa floor as seen through an intracranial approach. Drilling of the middle fossa floor was undertaken through both the originally described "anteromedial" approach, and a new "anterolateral" approach. Measurements were taken correlating the position of the IMAX to ipsilateral foramen rotundum, ipsilateral foramen ovale, posterior wall of the maxillary sinus, and distal V2 branches. Median and standard deviation were calculated for each dataset. The IMAX was found, within the pterygopalatine fossa, by drilling the greater wing of the sphenoid bone on average 10 mm anteriorly and 5 mm laterally to foramen rotundum, at an average depth of 8 mm. The IMAX was also found inferiorly to the maxillary nerve and laterally to the pterygoid head of the lateral pterygoid muscle. A more laterally oriented approach, consisting of drilling the greater wing of the sphenoid bone from a point perpendicular to foramen rotundum posteriorly to the sphenotemporal suture anteriorly, allowed for a longer segment of the IMAX to be easily identified and exposed facilitating its use as a donor vessel in bypass procedures. This cadaveric study provides a reliable and reproducible set of measurements to localize the IMAX within the pterygopalatine fossa through an intracranial middle fossa approach. The ability to find the IMAX consistently is an important step in exploring the possibility of using the IMAX as a routine donor vessel for EC-IC bypass procedures.

show abstract

Short Segment Internal Maxillary Artery to Middle Cerebral Artery Bypass: A Novel Technique for Extracranial-to-Intracranial Bypass

Cited by 8 publications

References 0 publications

Microsurgical anatomy of the maxillary artery for extracranial‐intracranial bypass in the pterygopalatine segment of the maxillary artery

Microsurgical anatomy of the maxillary artery for extracranial‐intracranial bypass in the pterygopalatine segment of the maxillary artery

25 Skull Base Approaches in Cerebrovascular Surgery

Localization of the Internal Maxillary Artery for Extracranial-to-Intracranial Bypass through the Middle Cranial Fossa: A Cadaveric Study

Contact Info

Product

Resources

About