National Brain Aneurysm & Tumor Center, Department of Neurosurgery, United Hospital, Twin Cities, MN, USA.
Minnesota Neurovascular & Skull Base Surgery, 3033 Excelsior Blvd, Suite 495, Minneapolis, MN, 55416, USA.
Acta Neurochir (Wien). 2020 Jan;162(1):183-186. doi: 10.1007/s00701-019-04145-3. Epub 2019 Nov 20.
The standard superficial temporal artery to middle cerebral artery (STA-MCA) bypass depends on adequate antegrade flow in the STA. In the setting of occlusion of the common or external carotid arteries, revascularization requires modification of the standard bypass procedure. A patient with prior history of irradiation for head and neck carcinoma presented with an ischemic injury and fluctuating neurologic deficit not responsive to medical therapy. His left common carotid artery was occluded, but angiographic evaluation demonstrated retrograde filling of his left STA. Reverse STA-MCA bypass was performed, taking advantage of spontaneous collateralization which allowed for retrograde filling of the STA.
标准的颞浅动脉到大脑中动脉（STA-MCA）搭桥术依赖于 STA 中的足够顺行血流。在颈总或颈外动脉闭塞的情况下，需要对标准搭桥术进行修改。一位有头颈部癌放疗史的患者出现了缺血性损伤和波动性神经功能缺损，对药物治疗无反应。他的左侧颈总动脉闭塞，但血管造影评估显示左侧 STA 逆行充盈。进行了逆行 STA-MCA 搭桥术，利用自发性侧支循环使 STA 逆行充盈。
