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Revascularization of the upper posterior circulation with the anterior temporal artery: an anatomical feasibility study.
J Neurosurg 2018; 129(1):121-127JN

Abstract

OBJECTIVE

In various disease processes, including unclippable aneurysms, a bypass to the upper posterior circulation (UPC) including the superior cerebellar artery (SCA) and posterior cerebral artery (PCA) may be needed. Various revascularization options exist, but the role of intracranial (IC) donors has not been scrutinized. The objective of this study was to evaluate the anatomical feasibility of utilizing the anterior temporal artery (ATA) for revascularization of the UPC.

METHODS

ATA-SCA and ATA-PCA bypasses were performed on 14 cadaver specimens. After performing an orbitozygomatic craniotomy and opening the basal cisterns, the ATA was divided at the M3-M4 junction and mobilized to the crural cistern to complete an end-to-side bypass to the SCA and PCA. The length of the recipient artery between the anastomosis and origin was measured.

RESULTS

Seventeen ATAs were found. Successful anastomosis was performed in 14 (82%) of the ATAs. The anastomosis point on the PCA was 14.2 mm from its origin on the basilar artery. The SCA anastomosis point was 10.1 mm from its origin. Three ATAs did not reach the UPC region due to a common opercular origin with the middle temporal artery. The ATA-SCA bypass was also applied to the management of an incompletely coiled SCA aneurysm.

CONCLUSIONS

The ATA is a promising IC donor for UPC revascularization. The ATA is exposed en route to the proximal SCA and PCA through the pterional-orbitozygomatic approach. Also, the end-to-side anastomosis provides an efficient and straightforward bypass without the need to harvest a graft or perform multiple or difficult anastomoses.

Authors+Show Affiliations

1Department of Neurological Surgery. 2Skull Base and Cerebrovascular Laboratory, and.1Department of Neurological Surgery. 2Skull Base and Cerebrovascular Laboratory, and.1Department of Neurological Surgery. 2Skull Base and Cerebrovascular Laboratory, and.2Skull Base and Cerebrovascular Laboratory, and.2Skull Base and Cerebrovascular Laboratory, and.1Department of Neurological Surgery. 2Skull Base and Cerebrovascular Laboratory, and.1Department of Neurological Surgery. 2Skull Base and Cerebrovascular Laboratory, and.1Department of Neurological Surgery. 3Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California.

Pub Type(s)

Journal Article
Video-Audio Media

Language

eng

PubMed ID

28937325

Citation

Tayebi Meybodi, Ali, et al. "Revascularization of the Upper Posterior Circulation With the Anterior Temporal Artery: an Anatomical Feasibility Study." Journal of Neurosurgery, vol. 129, no. 1, 2018, pp. 121-127.
Tayebi Meybodi A, Lawton MT, Griswold D, et al. Revascularization of the upper posterior circulation with the anterior temporal artery: an anatomical feasibility study. J Neurosurg. 2018;129(1):121-127.
Tayebi Meybodi, A., Lawton, M. T., Griswold, D., Mokhtari, P., Payman, A., Tabani, H., ... Benet, A. (2018). Revascularization of the upper posterior circulation with the anterior temporal artery: an anatomical feasibility study. Journal of Neurosurgery, 129(1), pp. 121-127. doi:10.3171/2017.3.JNS162865.
Tayebi Meybodi A, et al. Revascularization of the Upper Posterior Circulation With the Anterior Temporal Artery: an Anatomical Feasibility Study. J Neurosurg. 2018;129(1):121-127. PubMed PMID: 28937325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Revascularization of the upper posterior circulation with the anterior temporal artery: an anatomical 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 - Benet,Arnau, Y1 - 2017/09/22/ PY - 2017/9/25/pubmed PY - 2019/10/11/medline PY - 2017/9/23/entrez KW - ATA = anterior temporal artery KW - EC = extracranial KW - IC = intracranial KW - MCA = middle cerebral artery KW - PCA = posterior cerebral artery KW - RAG = radial artery graft KW - SCA = superior cerebellar artery KW - STA = superficial temporal artery KW - UPC = upper posterior circulation KW - anatomy KW - basilar apex aneurysm KW - cerebral revascularization KW - oculomotor-tentorial triangle KW - orbitozygomatic craniotomy KW - posterior cerebellar artery KW - superior cerebellar artery KW - vascular disorders KW - vascular insufficiency syndrome SP - 121 EP - 127 JF - Journal of neurosurgery JO - J. Neurosurg. VL - 129 IS - 1 N2 - OBJECTIVE In various disease processes, including unclippable aneurysms, a bypass to the upper posterior circulation (UPC) including the superior cerebellar artery (SCA) and posterior cerebral artery (PCA) may be needed. Various revascularization options exist, but the role of intracranial (IC) donors has not been scrutinized. The objective of this study was to evaluate the anatomical feasibility of utilizing the anterior temporal artery (ATA) for revascularization of the UPC. METHODS ATA-SCA and ATA-PCA bypasses were performed on 14 cadaver specimens. After performing an orbitozygomatic craniotomy and opening the basal cisterns, the ATA was divided at the M3-M4 junction and mobilized to the crural cistern to complete an end-to-side bypass to the SCA and PCA. The length of the recipient artery between the anastomosis and origin was measured. RESULTS Seventeen ATAs were found. Successful anastomosis was performed in 14 (82%) of the ATAs. The anastomosis point on the PCA was 14.2 mm from its origin on the basilar artery. The SCA anastomosis point was 10.1 mm from its origin. Three ATAs did not reach the UPC region due to a common opercular origin with the middle temporal artery. The ATA-SCA bypass was also applied to the management of an incompletely coiled SCA aneurysm. CONCLUSIONS The ATA is a promising IC donor for UPC revascularization. The ATA is exposed en route to the proximal SCA and PCA through the pterional-orbitozygomatic approach. Also, the end-to-side anastomosis provides an efficient and straightforward bypass without the need to harvest a graft or perform multiple or difficult anastomoses. SN - 1933-0693 UR - https://www.unboundmedicine.com/medline/citation/28937325/Revascularization_of_the_upper_posterior_circulation_with_the_anterior_temporal_artery:_an_anatomical_feasibility_study_ L2 - https://thejns.org/doi/10.3171/2017.3.JNS162865 DB - PRIME DP - Unbound Medicine ER -