An interposed superficial temporal artery graft bypass for anterior cerebral artery ischemia.

A new microsurgical revascularization technique for anterior cerebral artery ischemia is reported. An arterial graft bypass interposed between the superficial temporal artery and the distal anterior cerebral artery was successfully completed in a 43-year-old male with transient ischemic attacks in the anterior cerebral artery territory. The contralateral superficial temporal artery was harvested and used as an arterial graft. Both procedures were carried out with one single transcoronal scalp incision. The patient's postoperative cerebral angiogram revealed good filling of the area distal to the stenotic lesion of the anterior cerebral artery through the bypass graft. The patient was discharged with no neurological deficit and has been free of ischemic events for more than 2 years since the surgery. If the bilateral superficial temporal arteries are fairly well developed, the ipsilateral superficial temporal artery can be used as an arterial graft for revascularization of the anterior cerebral artery territory.