Superficial Temporal Artery: Distal Posterior Cerebral Artery Bypass through the Subtemporal Approach: Technical Note and Pilot Surgical Cases

Operative Neurosurgery
Akitsugu KawashimaJuha Hernesniemi

Abstract

Posterior cerebral artery (PCA) aneurysms are rare and the majority are fusiform in shape. Proximal occlusion of PCA represents a treatment option for these lesions. However, this procedure carries a high risk of ischemic complications. To describe the technique of trapping a fusiform PCA aneurysm and revascularization of the distal PCA using a superficial temporal artery (STA) graft through the same microsurgical approach. From September 2012 to October 2014, we retrospectively identified 3 patients harboring a fusiform PCA aneurysm (P2 segment aneurysm) who underwent trapping of the aneurysm and reconstruction of the distal PCA through the same subtemporal approach. We analyzed immediate morbidity, surgical complications, and the patency of the bypass to determine the feasibility of this procedure. All 3 patients underwent successful trapping of the fusiform PCA aneurysm and revascularization of the distal PCA. The origin of P3 segment or posterior temporal artery (PTA) served as recipient arteries. In all 3 cases, adequate blood flow was evident after performing the STA-P3/PTA bypass. None of the patients experienced a new permanent neurological deficit. At 1-year follow-up, the STA-PTA/PCA bypasses remained patent. The STA-...Continue Reading

References

Dec 29, 1998·The New England Journal of Medicine·UNKNOWN International Study of Unruptured Intracranial Aneurysms Investigators
Jan 7, 2005·Neurosurgical Focus·Francisco A PonceRobert F Spetzler
Aug 3, 2005·Acta Neurochirurgica. Supplement·J HernesniemiH Shen
Feb 17, 2015·World Neurosurgery·Felix GoehreJuha A Hernesniemi

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Citations

Apr 11, 2019·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Alexander SpiessbergerBernhard Moriggl
Mar 15, 2018·Neurosurgical Review·L WesselsP Vajkoczy

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