Volume 153, Number 8, 1645-1648, DOI: 10.1007/s00701-011-1035-0

Dissection of both frontal and parietal branches of the superficial temporal artery for bypass surgery through a single linear skin incision

Yoji Tamura, Atsushi Aoki, Yoshitaka Yamada, Naosuke Nonoguchi, Ryokichi Yagi, Adam Tucker and Toshihiko Kuroiwa

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Abstract

Background  

Double superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery has typically involved more than one linear incision. In this report, we demonstrate how the procedure can be performed through a single linear skin incision over the parietal branch of the STA.

Methods  

Initial dissection of the parietal branch and creation of a subcutaneous cavity along the frontal branch were performed using the conventional microscopic method. Detailed additional dissection and isolation of the frontal branch were accomplished with the aid of an endoscopic retractor.

Results  

This procedure was performed in five patients for harvesting of approximately 8- and 5-cm lengths of the parietal and frontal branches, respectively. The resultant lengths of the harvested vessels were sufficient for anastomotic revascularization of MCA recipient arteries in both the frontal and temporal lobes.

Conclusion  

This method can be safely performed with achievement of a less invasive dissection of the STA and an overall improved cosmetic outcome.

Keywords  Bypass surgery – Superficial temporal artery – Frontal branch – Endoscope

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