Abstract：
BACKGROUND:Direct extracranial-intracranial (EC-IC) bypass is one of the fundamental techniques to prevent recurrent stroke in patients with adult-onset ischemic moyamoya disease. When the standard superficial temporal artery (STA) cannot be used for a graft, the posterior auricular artery (PAA) can be a potential surrogate graft. CASE DESCRIPTION:In this article, the authors reported a 34-year-old female patient suffering from ischemic moyamoya disease. To widely revascularize the anterior half of the hemisphere, direct double EC-IC bypass was considered beneficial; however, she had only a single-branched STA but had a prominent branch of the PAA. After discussion, a direct double surgical revascularization was successfully performed using a combination of the STA-middle cerebral artery (MCA) and the PAA-MCA bypass. The authors herein reported the detailed surgical technique of the PAA-MCA bypass with an informative video of the actual procedure. To clearly define the feasibility of PAA-MCA bypass, the authors also conducted a literature review, yielding 3 previous articles describing the bypass. CONCLUSION:In conclusion, the PAA becomes a potential donor for EC-IC bypass as long as its diameter is approximately 1.0 mm. Even though the PAA-MCA bypass is not primarily considered in the initial revascularization, it can be useful as a combination bypass with other grafts or as a rescue for recurrent ischemia.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Torazawa S,Hasegawa H,Kin T,Sato H,Sora Sdoi
10.1016/j.wneu.2017.09.005subject
Has Abstractpub_date
2017-12-01 00:00:00pages
994.e1-994.e5eissn
1878-8750issn
1878-8769pii
S1878-8750(17)31508-5journal_volume
108pub_type
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journal_title：World neurosurgery
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