Abstract:
OBJECTIVE:To introduce a method for preoperative targeting of a proper recipient artery in superficial temporal artery-to-middle cerebral artery anastomosis. METHODS:Six operations for superficial temporal artery-to-middle cerebral artery anastomosis in four patients with moyamoya disease or moyamoya-like disease and two operations in two patients with atherosclerotic cerebrovascular occlusive disease accompanied by coronary artery stenosis were performed using our method. Before surgery, a 3-Tesla magnetic resonance imaging study was performed with axial T1-weighted three-dimensional magnetization-prepared rapid acquisition gradient-echo sequences and three-dimensional time-of-flight magnetic resonance angiography. Data on quantitative regional cerebral blood flow were obtained by iodine-123-labeled N-isopropyl-iodoamphetamine single-photon emission computed tomography or positron emission computed tomography. The magnetic resonance angiography and regional cerebral blood flow data sets were registered with the magnetization-prepared rapid acquisition gradient-echo data set by means of the coregistration function of the SPM2 software. We examined the arteries located on or near the cortex where the regional cerebral blood flow had significantly decreased and used the coregistered data set and MRIcro software to select the cortical artery with the largest diameter as the target recipient artery. At the surgery, the data sets were applied to the neuronavigation system and the actual site of the target was confirmed in the operation before scalp incision. The superficial temporal artery was anastomosed with the target through a small craniotomy. RESULTS:Successful bypass surgery to the target was confirmed in all cases. CONCLUSION:The "target bypass" method might be effective for cases with moyamoya disease or for cases requiring surgery through a small craniotomy.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Kikuta K,Takagi Y,Fushimi Y,Ishizu K,Okada T,Hanakawa T,Miki Y,Fukuyama H,Nozaki K,Hashimoto Ndoi
10.1227/01.NEU.0000232775.06672.F4subject
Has Abstractpub_date
2006-10-01 00:00:00pages
ONS320-6; discussion ONS326-7issue
4 Suppl 2eissn
0148-396Xissn
1524-4040pii
00006123-200610001-00012journal_volume
59pub_type
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