Summary
We describe the case of a 47-year-old female with symptomatic right MCA stenosis who had undergone cerebral revascularization through a superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass. Despite clear patency in the operating room, post-operative angiography showed no flow in the bypass. Her ipsilateral internal carotid artery (ICA) was widely patent. She remained asymptomatic and follow-up angiography four years later showed a widely patent bypass graft in the setting of critical stenosis of the ipsilateral ICA. That the graft was found opened up and supplying the hemisphere was presumably stimulated by an increased “demand” and flow gradient promoting its patency.
References
BT Andrews NL Chater PR Weinstein (1985) ArticleTitleExtracranial-intracranial arterial bypass for middle cerebral artery stenosis and occlusion: operative results in 65 cases J Neurosurg 62 831–838 Occurrence Handle3998831 Occurrence Handle1:STN:280:DyaL2M3htVWjsw%3D%3D
RE Latchaw JI Ausman MC Lee (1979) ArticleTitleSuperficial temporal-middle cerebral artery bypass. A detailed analysis of multiple pre- and postoperative angiograms in 40 consecutive patients J Neurosurg 51 IssueID4 455–465 Occurrence Handle479932 Occurrence Handle1:STN:280:DyaL3c%2FgvVeitg%3D%3D
I Awad A Furlan JR Little (1984) ArticleTitleChanges in intracranial stenotic lesions after extracranial-intracranial bypass surgery J Neurosurg 60 771–776 Occurrence Handle6707746 Occurrence Handle1:STN:280:DyaL2c7msVSqtQ%3D%3D
AL Day AL Rhoton R Quisling (1980) ArticleTitleResolving siphon stenosis following endarterectomy Stroke 11 278–281 Occurrence Handle7394865 Occurrence Handle1:STN:280:DyaL3c3jslSisA%3D%3D
InstitutionalAuthorNameThe EC/IC Bypass Study Group (1985) ArticleTitleFailure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial N Engl J Med 313 IssueID19 1191–1200 Occurrence Handle10.1056/NEJM198511073131904
AJ Furlan JR Little DF Dohn (1980) ArticleTitleArterial occlusion following anastomosis of the superficial temporal artery to middle cerebral artery Stroke 11 91–95 Occurrence Handle7355438 Occurrence Handle1:STN:280:DyaL3c7isV2hug%3D%3D
MK Gumerlock H Ono EA Neuwelt (1983) ArticleTitleCan a patent extracranial-intracranial bypass provoke the conversion of an intracranial arterial stenosis to a symptomatic occlusion? Neurosurgery 12 391–400 Occurrence Handle6856063 Occurrence Handle1:STN:280:DyaL3s3hvFGrsQ%3D%3D
CR Jack TM Sundt SuffixJr NC Fode DG Gehring (1988) ArticleTitleSuperficial temporal-middle cerebral artery bypass: clinical pre- and postoperative angiographic correlation J Neurosurg 69 46–45 Occurrence Handle3379476 Occurrence Handle10.3171/jns.1988.69.1.0046
MT Lawton MG Hamilton JJ Morcos RF Spetzler (1996) ArticleTitleRevascularization and aneurysm Neurosurgery 38 83–94 Occurrence Handle8747955 Occurrence Handle10.1097/00006123-199601000-00020 Occurrence Handle1:STN:280:DyaK28zlsVSiuw%3D%3D
RF Spetzler H Schuster RA Roski (1980) ArticleTitleElective extracranial-intracranial arterial bypass in the treatment of inoperable giant aneurysms of the internal carotid artery J Neurosurg 53 22–27 Occurrence Handle7411205 Occurrence Handle1:STN:280:DyaL3M%2FgvVOgtQ%3D%3D
TM Sundt SuffixJr JP Whisnant NC Fode DG Piepgras OW Houser (1985) ArticleTitleResults, complications, and follow-up of 415 bypass operations for occlusive disease of the carotid system Mayo Clin Proc 60 IssueID4 230–240 Occurrence Handle3982075
JE Wanebo JM Zabramski RF Spetzler (2004) ArticleTitleSuperficial temporal artery-to-middle cerebral artery bypass grafting for cerebral revascularization Neurosurgery 55 IssueID2 395–398 Occurrence Handle15271247 Occurrence Handle10.1227/01.NEU.0000129549.99061.94
MG Yasargil (Eds) (1969) Microsurgery applied to neurosurgery Georg Thieme Stuttgart Stuttgart 105–115
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dunn, I., Ellegala, D. & Day, A. Delayed re-opening of an STA-MCA bypass graft. Acta Neurochir (Wien) 148, 1001–1004 (2006). https://doi.org/10.1007/s00701-006-0851-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-006-0851-0