STA-Distal ACA Bypass Using a Contralateral STA Interposition Graft for Symptomatic ACA Stenosis.
10.7461/jcen.2018.20.3.191
- Author:
Yoon Ha HWANG
1
;
Young Sub KWON
;
Yun Ho LEE
Author Information
1. Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Anterior cerebral artery;
Cerebral revascularization;
Infarction;
Temporal arteries
- MeSH:
Anterior Cerebral Artery;
Arteries;
Atherosclerosis;
Carotid Artery, Internal;
Cerebral Revascularization;
Constriction, Pathologic*;
Dysarthria;
Humans;
Infarction;
Magnetic Resonance Imaging;
Middle Aged;
Middle Cerebral Artery;
Stroke;
Temporal Arteries;
Transplants*
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2018;20(3):191-197
- CountryRepublic of Korea
- Language:English
-
Abstract:
Intracranial arterial stenosis usually occurs due to atherosclerosis and is considered the most common cause of stroke worldwide. Although the effectiveness of bypass surgery for ischemic stroke is controversial, the superficial temporal artery to the middle cerebral artery bypass for ischemic stroke is a common procedure. In our report, a 50-year-old man presented with sudden-onset left side weakness and dysarthria. An angiogram showed significant stenosis in the junction of the right cavernous-supraclinoid internal carotid artery and right pericallosal artery. Symptoms altered between improvement and deterioration. Magnetic resonance imaging showed a repeated progression of anterior cerebral artery (ACA) infarction despite maximal medical therapy. We performed a STA-ACA bypass with contralateral STA interposition. Postoperative course was uneventful with no further progression of symptoms. Thus, bypass surgery may be considered in patients with symptomatic stenosis or occlusion of the ACA, especially when patients present progressive symptoms despite maximal medical therapy.
