Ulku Cagatay Han, Cicekcibasi Aynur Emine, Cengiz Sahika Liva, Ustun Mehmet Erkan, Buyukmumcu Mustafa
Department of Otolaryngology, Head and Neck Surgery, Selcuk University, Akyokuş, Konya, Turkey.
Neurosurg Rev. 2009 Jan;32(1):95-9; discussion 99. doi: 10.1007/s10143-008-0157-1. Epub 2008 Sep 5.
The aim of the present study was to investigate the use of a radial artery graft (RAG) for bypass of the proximal superficial temporal artery (STA) to proximal posterior cerebral artery (PCA) by posterior oblique transzygomatic subtemporal approach as an alternative to the external carotid artery (ECA) to PCA anastomosis. We conducted an anatomical and technical study at a university hospital. Five adult cadaveric specimens were dissected. A preauricular vertical skin incision was used. The trunk of STA was identified. A 30 degrees oblique posterior zygomatic arch osteotomy and microcraniotomy was performed. The dura of the middle cranial fossa was then opened. The temporal lobe was retracted, the interpeduncular and ambient cisterns were opened, and the P2 segment of the PCA was exposed. The proximal side of the RAG was anastomosed with the proximal STA and the distal side was anastomosed with the P2 segment. The mean caliber of the proximal STA was 2.25 +/- 0.35 mm. The mean diameter of the P(2) was 2.2 +/- 0.2 mm. The average length of the RAG was 56 +/- 3.2 mm. The mean caliber of the proximal and the distal sides of the graft was 2.5 +/- 0.25 mm and 2.3 +/- 0.15 mm, respectively. Because the proximal STA to proximal PCA bypass uses a short RAG and their calibers are over 2 mm, this bypass technique can provide a sufficient blood flow and may be a reasonable alternative over ECA to PCA bypass using long grafts.
本研究的目的是探讨采用后斜经颧颞下入路，使用桡动脉移植物（RAG）将颞浅动脉（STA）近端与大脑后动脉（PCA）近端进行搭桥，作为颈外动脉（ECA）至PCA吻合术的替代方法。我们在一家大学医院进行了一项解剖学和技术研究。解剖了5个成年尸体标本。采用耳前垂直皮肤切口。确定STA主干。进行30度后斜颧弓截骨和微型开颅手术。然后打开中颅窝硬脑膜。牵开颞叶，打开脚间池和环池，暴露PCA的P2段。将RAG的近端与STA近端吻合，远端与P2段吻合。STA近端的平均管径为2.25±0.35毫米。P2的平均直径为2.2±0.2毫米。RAG的平均长度为56±3.2毫米。移植物近端和远端的平均管径分别为2.5±0.25毫米和2.3±0.15毫米。由于STA近端至PCA近端搭桥使用短的RAG且其管径超过2毫米，这种搭桥技术可提供足够的血流，可能是使用长移植物的ECA至PCA搭桥的合理替代方法。
