EC-IC bypass using the distal stump of the superficial temporal artery as an additional collateral source of blood flow in patients with Moyamoya disease.

Abstract

To establish multiple bypass flow in an adult Moyamoya disease patient, the distal stump of the parietal superficial temporal artery (dsPSTA) was used as an additional donor. Its potential as the donor was first evaluated by measuring the arterial pressure directly in three patients, revealing about 80% in mean arterial pressure of those measured at the proximal stump and radial artery. The anastomosis was performed just as conventionally except an additional anastomosis between the dsPSTA and frontal branch of the middle cerebral artery in 10 hemispheres of 7 patients. The patency of the dsPSTA bypass was confirmed on postoperative angiography in 5 patients. The comparison of pre- and post-operative single photon emission computed tomography was feasible in 8 hemispheres of 6 patients of which 7 demonstrated improvement of the cerebral blood flow. CONCLUSION; This technique provides a novel source of donor artery in the treatment of Moyamoya disease, in which multiple anastomoses are desirable.