World neurosurgery · 2022
One-Stage Revascularization to the Ipsilateral Middle Cerebral Artery and Contralateral Anterior Cerebral Artery Territories.
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Tsunoda Sho, Inoue Tomohiro, Segawa Masafumi, Akabane Atsuya
Аннотация
BACKGROUND: Patients with multiple intracranial atherosclerotic stenoses often present with hemodynamic instability in 2 remote regions without a reciprocal vascular network. In this situation, revascularization to each region may be required.
METHODS: In this report, 2 patients who had coexisting unilateral middle cerebral artery (MCA) and contralateral anterior cerebral artery territory ischemia were treated by using ipsilateral superficial temporal artery (STA)-radial artery graft-contralateral A3 bypass and ipsilateral STA-MCA bypass in one stage.
RESULTS: Postoperatively, the bypass conduit was well established, and the patients' hemodynamic instability was improved.
CONCLUSIONS: In patients with severe hemodynamic instability in the remote unilateral MCA and contralateral anterior cerebral artery regions, as in our 2 cases, ipsilateral STA-MCA and ipsilateral STA-radial artery graft-contralateral A3 bypasses in one stage can be a treatment option.
METHODS: In this report, 2 patients who had coexisting unilateral middle cerebral artery (MCA) and contralateral anterior cerebral artery territory ischemia were treated by using ipsilateral superficial temporal artery (STA)-radial artery graft-contralateral A3 bypass and ipsilateral STA-MCA bypass in one stage.
RESULTS: Postoperatively, the bypass conduit was well established, and the patients' hemodynamic instability was improved.
CONCLUSIONS: In patients with severe hemodynamic instability in the remote unilateral MCA and contralateral anterior cerebral artery regions, as in our 2 cases, ipsilateral STA-MCA and ipsilateral STA-radial artery graft-contralateral A3 bypasses in one stage can be a treatment option.