Kimura Toshikazu, Morita Akio
Department of Neurosurgery, Japanese Red Cross Medical Center, Tokyo, Japan.
Department of Neurosurgery, Nippon Medical University, Tokyo, Japan.
World Neurosurg. 2017 Dec;108:201-205. doi: 10.1016/j.wneu.2017.08.126. Epub 2017 Sep 21.
Superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis is a common procedure for vascular neurosurgeons, and it is used in a variety of diseases. However, there are cases in which the STA is absent or is too hypoplastic to be used as a donor for revascularization. Occipital artery (OA)-MCA bypass may be a treatment option in these cases.
We encountered 4 cases of symptomatic cerebral ischemia in which the STA was absent or unavailable. These cases were treated by revascularization from the OA to the periphery of the MCA.
By meticulous dissection of the OA to the level of the superior temporal line, the OA could reach the periphery of the angular artery and be anastomosed to it in the usual fashion. The patency of the donor artery was confirmed by magnetic resonance angiography soon after the operation and 3 years later.
OA-MCA bypass may be a surgical option for cerebral revascularization when the STA is not available.
颞浅动脉（STA）-大脑中动脉（MCA）吻合术是血管神经外科医生常用的手术方法，用于多种疾病。然而，存在颞浅动脉缺如或发育不良而无法用作血管重建供体的情况。枕动脉（OA）-MCA搭桥术可能是这些情况下的一种治疗选择。
我们遇到4例有症状的脑缺血患者，其颞浅动脉缺如或无法使用。这些病例通过从枕动脉到大脑中动脉周围进行血管重建来治疗。
通过将枕动脉细致解剖至颞上线水平，枕动脉可到达角动脉周围并以常规方式与之吻合。术后不久及3年后通过磁共振血管造影证实了供体动脉的通畅性。
当无法使用颞浅动脉时，枕动脉-大脑中动脉搭桥术可能是一种脑血运重建的手术选择。
