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Paul Steinbok, Kenneth Berry and Clarisse L. Dolman

S ince the first published reports of bypass surgery in humans for intracranial vascular occlusive disease by Yaşargil, et al., in 1970, 21 there have been an estimated 1000 such operations performed. 5 Discussions of the techniques, indications, results, and assessment of patency of anastomosis have been the subject of a number of international symposia as well as a large number of publications. 2, 14, 16 While the vast majority of such operations are superficial temporal artery to middle cerebral artery (STA-MCA) anastomoses for transient ischemic

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Kazushi Kinugasa, Tomohide Maeshiro, Masaru Sakurai and Takashi Ohmoto

S ince its inception, the extracranial-intracranial arterial bypass procedure has undergone a number of modifications in efforts to treat patients with occlusive cerebrovascular disease. 3, 7, 12 We report a case in which the superficial temporal artery (STA) was used as an interposition graft to revascularize an area in which partial resection of both anterior cerebral arteries (ACA's) was required for tumor removal. Case Report This 28-year-old woman presented with a 3-year history of nasal obstruction and bilateral anosmia. Before presenting to our

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Ali Alaraj, William W. Ashley Jr., Fady T. Charbel and Sepideh Amin-Hanjani

measuring the cut flow: the superficial temporal artery is dissected, the distal end cut open, and the blood flow is measured using the Transonic Flowprobe. TABLE 1 Summary of intraoperative flow measurements of the distal stump and proximal stump as well as the final bypass flow after the bypass has been constructed Case No. Diagnosis Bypass Type Distal STA Cut Flow Proximal STA Cut Flow Bypass Flow Measurement 1 * ischemia STA-PCA — 54 ml/min 45 ml/min 2 basilar occlusion STA-PCA 10 ml/min 60 ml

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Fernando G. Diaz, Jacob Chason, Carl Shrontz, James I. Ausman and Manuel Dujovny

T he treatment of cerebrovascular disease has recently included extracranial-intracranial anastomosis for the revascularization of lesions previously inaccessible to surgery. 3, 9–12 While the superficial temporal artery (STA) has been considered a “normal artery,” some histological arterial changes have been described. 1, 9–11, 13 This paper deals with the histological characteristics of a cumulative series of these vessels used for cerebral revascularization. Various factors that may have an ultimate effect on the long-term patency, patient survival, and

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Ryoji Ishii, Tetsuo Koike, Shigekazu Takeuchi, Shigeaki Ohsugi, Ryuichi Tanaka and Kimikazu Konno

D onaghy and Yaşargil first performed a micro-vascular anastomosis between the superficial temporal artery (STA) and a cortical branch of the middle cerebral artery (MCA) in 1967 (unpublished data). Since then, a number of new procedures of extracranial-intracranial arterial anastomosis have been increasingly used as a method to create a collateral circulation capable of restoring normal circulatory capacity and preventing further cerebral ischemia. We report our experience with an interposed cephalic vein graft between the STA and the distal anterior cerebral

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Yasuhiko Kaku, Kentaro Yamashita, Jouji Kokuzawa, Kiyomitsu Kanou and Masanori Tsujimoto

DS , : Conscious sedation versus general anesthesia during endovascular therapy for acute anterior circulation stroke: preliminary results from a retrospective, multicenter study . Stroke 41 : 1175 – 1179 , 2010 2 Bilotta F , Rosa G : ‘Anesthesia’ for awake neurosurgery . Curr Opin Anaesthesiol 22 : 560 – 565 , 2009 3 Coppens JR , Cantando JD , Abdulrauf SI : Minimally invasive superficial temporal artery to middle cerebral artery bypass through an enlarged bur hole: the use of computed tomography angiography neuronavigation in surgical

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Jun-ichiro Hamada, Tatemi Todaka, Shigetoshi Yano, Yutaka Kai, Motohiro Morioka and Yukitaka Ushio

9. Marano SR , Fischer DW , Gaines C , et al : Anatomical study of the superficial temporal artery. Neurosurgery 16 : 786 – 790 , 1985 Marano SR, Fischer DW, Gaines C, et al: Anatomical study of the superficial temporal artery. Neurosurgery 16: 786–790, 1985 10. Nagashima C , Iwama K , Sakata E , et al : Effects of temporary occlusion of a vertebral artery on the human vestibular system. J Neurosurg 33 : 388 – 394 , 1970 Nagashima C, Iwama K, Sakata E, et al: Effects of

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Soichi Oya, Masahiro Indo, Masabumi Nagashima and Toru Matsui

T he superficial temporal artery (STA)–superior cerebellar artery (SCA) bypass is an established method for SCA reconstruction, 2 , 14 and the preferred recipient sites are the anterior pontomesencephalic segments of the SCA, accessed through a pretemporal approach, or the lateral pontomesencephalic segments of the SCA that are accessed through a subtemporal approach. 13 However, it is difficult to expose these areas, and retracting the temporal lobe carries a risk of brain swelling or injury to the vein of Labbé. We report a case of a fusiform unruptured

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Superficial temporal artery to middle cerebral artery anastomosis

Intraoperative evaluation by fluorescein angiography and xenon-133 clearance

John R. Little, Y. Lucas Yamamoto, William Feindel, Ernst Meyer and Charles P. Hodge

C erebral blood flow (CBF) in patients undergoing superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis has been studied before and after surgery by Schmiedek, et al., 18 Yamamoto, et al., 12, 23, 24 and others. 1 , 14 These investigations demonstrated reduced regional cerebral blood flow (rCBF), usually multifocal, in the cerebral hemisphere ipsilateral to the occluded internal carotid artery (ICA) or MCA. The revascularization procedure consistently improved rCBF, and symptoms of cerebral ischemia invariably did not recur

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Toshiro Katsuta, Hiroshi Abe, Koichi Miki and Tooru Inoue

T he results of an extracranial-intracranial bypass study 1 in 1985 were discouraging. Likewise, use of superficial temporal artery (STA)–middle cerebral artery (MCA) bypass surgery for atherosclerotic steno-occlusive disease was denied based on its poor efficacy in a randomized trial 12 in 2011. Nevertheless, the usefulness of STAMCA anastomosis for moyamoya disease has been taken for granted for a long period of time. 5 Because the STA runs superficial to the temporalis muscle, it should be introduced to the cerebral surface by either perforating the