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Assessment of the Temporopolar Artery as a Donor Artery for Intracranial-Intracranial Bypass to the Middle Cerebral Artery: Anatomic Feasibility Study.
World Neurosurg 2017; 104:171-179WN

Abstract

BACKGROUND

Intracranial-intracranial bypass is a valuable cerebral revascularization option. Despite several advantages, one of the main shortcomings of the intracranial-intracranial bypass is the possibility of ischemic complications of the donor artery. However, when sacrificed, the temporopolar artery (TPA) is not associated with major neurologic deficits. We sought to define the role of TPA as a donor for revascularization of the middle cerebral artery (MCA).

METHODS

Pterional craniotomy was performed on 14 specimens. The TPA was released from arachnoid trabecula, and the small twigs to the temporal lobe were cut. The feasibility of side-to-side and end-to-side bypass to the farthest arterial targets on insular, opercular, and cortical MCA branches was assessed. The distance of the bypass point was measured in reference to limen insulae.

RESULTS

A total of 15 TPAs were assessed (1 specimen had 2 TPAs). The average cisternal length of the TPA was 37.3 mm. For side-to-side bypass, the TPA was a poor candidate as an intracranial donor, except for the cortical orbitofrontal artery, which was reached in 87% of cases. However, the end-to-side bypass was successfully completed for most arteries (87%-100%) on the anterior frontal operculum and more than 50% of the cortical or opercular middle and posterior temporal arteries. There was no correlation between the TPA's cisternal length and maximum bypass reach.

CONCLUSIONS

When of favorable diameter, the TPA is a competent donor for intracranial-intracranial bypass to MCA branches at the anterior insula, and anterior frontal and middle temporal opercula (arteries anterior to the precentral gyrus coronal plane).

Authors+Show Affiliations

Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA. Electronic address: beneta@neurosurg.ucsf.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28465270

Citation

Tayebi Meybodi, Ali, et al. "Assessment of the Temporopolar Artery as a Donor Artery for Intracranial-Intracranial Bypass to the Middle Cerebral Artery: Anatomic Feasibility Study." World Neurosurgery, vol. 104, 2017, pp. 171-179.
Tayebi Meybodi A, Lawton MT, Griswold D, et al. Assessment of the Temporopolar Artery as a Donor Artery for Intracranial-Intracranial Bypass to the Middle Cerebral Artery: Anatomic Feasibility Study. World Neurosurg. 2017;104:171-179.
Tayebi Meybodi, A., Lawton, M. T., Griswold, D., Mokhtari, P., Payman, A., Tabani, H., ... Benet, A. (2017). Assessment of the Temporopolar Artery as a Donor Artery for Intracranial-Intracranial Bypass to the Middle Cerebral Artery: Anatomic Feasibility Study. World Neurosurgery, 104, pp. 171-179. doi:10.1016/j.wneu.2017.04.142.
Tayebi Meybodi A, et al. Assessment of the Temporopolar Artery as a Donor Artery for Intracranial-Intracranial Bypass to the Middle Cerebral Artery: Anatomic Feasibility Study. World Neurosurg. 2017;104:171-179. PubMed PMID: 28465270.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of the Temporopolar Artery as a Donor Artery for Intracranial-Intracranial Bypass to the Middle Cerebral Artery: Anatomic Feasibility Study. AU - Tayebi Meybodi,Ali, AU - Lawton,Michael T, AU - Griswold,Dylan, AU - Mokhtari,Pooneh, AU - Payman,Andre, AU - Tabani,Halima, AU - Yousef,Sonia, AU - Kola,Olivia, AU - Benet,Arnau, Y1 - 2017/04/29/ PY - 2017/01/24/received PY - 2017/04/20/revised PY - 2017/04/21/accepted PY - 2017/5/4/pubmed PY - 2017/9/26/medline PY - 2017/5/4/entrez KW - Anastomosis KW - Cerebral revascularization KW - Complex intracranial aneurysms KW - Intracranial-intracranial bypass KW - Middle cerebral artery KW - Temporopolar artery SP - 171 EP - 179 JF - World neurosurgery JO - World Neurosurg VL - 104 N2 - BACKGROUND: Intracranial-intracranial bypass is a valuable cerebral revascularization option. Despite several advantages, one of the main shortcomings of the intracranial-intracranial bypass is the possibility of ischemic complications of the donor artery. However, when sacrificed, the temporopolar artery (TPA) is not associated with major neurologic deficits. We sought to define the role of TPA as a donor for revascularization of the middle cerebral artery (MCA). METHODS: Pterional craniotomy was performed on 14 specimens. The TPA was released from arachnoid trabecula, and the small twigs to the temporal lobe were cut. The feasibility of side-to-side and end-to-side bypass to the farthest arterial targets on insular, opercular, and cortical MCA branches was assessed. The distance of the bypass point was measured in reference to limen insulae. RESULTS: A total of 15 TPAs were assessed (1 specimen had 2 TPAs). The average cisternal length of the TPA was 37.3 mm. For side-to-side bypass, the TPA was a poor candidate as an intracranial donor, except for the cortical orbitofrontal artery, which was reached in 87% of cases. However, the end-to-side bypass was successfully completed for most arteries (87%-100%) on the anterior frontal operculum and more than 50% of the cortical or opercular middle and posterior temporal arteries. There was no correlation between the TPA's cisternal length and maximum bypass reach. CONCLUSIONS: When of favorable diameter, the TPA is a competent donor for intracranial-intracranial bypass to MCA branches at the anterior insula, and anterior frontal and middle temporal opercula (arteries anterior to the precentral gyrus coronal plane). SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/28465270/Assessment_of_the_Temporopolar_Artery_as_a_Donor_Artery_for_Intracranial_Intracranial_Bypass_to_the_Middle_Cerebral_Artery:_Anatomic_Feasibility_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(17)30650-2 DB - PRIME DP - Unbound Medicine ER -