Superficial Temporal Artery-Posterior Cerebral Artery Bypass for the Treatment of Chronic Basilar Artery Occlusion

World Neurosurg. 2021 Jun:150:e45-e51. doi: 10.1016/j.wneu.2021.02.068. Epub 2021 Feb 23.

Abstract

Objective: To investigate the effect of superficial temporal artery-posterior cerebral artery (STA-PCA) bypass on chronic basilar artery occlusion (CBAO).

Methods: A total of 4 patients who underwent STA-PCA bypass between January 2018 and October 2019 were enrolled in this study. Cerebral blood perfusion, ischemic events, STA diameter and blood flow changes, modified Rankin scale score (mRS), and National Institutes of Health Stroke Scale (NIHSS) score changes were recorded before and after bypass surgery.

Results: The average time from basilar artery occlusion (confirmed by cerebral angiography or computed tomography angiography) to operation was 76 ± 38.89 days (range: 30-120 days). Average scores on the NIHSS were 6.8 ± 1.26 (5-8) and 5.2 ± 2.06 (3-7) before and after treatment, respectively. mRS scores averaged 1.8 ± 0.5 (1-2) and 1.5 ± 0.58 (1-2) points, respectively. There were no obvious complications or further stroke during the follow-up. The STA diameter and flow rate were significantly increased at 12 months after operation (P < 0.05).

Conclusions: STA-PCA bypass can improve cerebral blood flow perfusion in CBAO patients. The diameter and flow of the superficial temporal artery can be increased to meet the demand of blood supply.

Keywords: Basilar artery occlusion; Ischemic stroke; Posterior circulation ischemia; Superficial temporal artery–posterior cerebral artery bypass.

MeSH terms

  • Aged
  • Cerebral Angiography
  • Cerebral Revascularization / methods*
  • Cerebrovascular Circulation
  • Chronic Disease
  • Female
  • Humans
  • Male
  • Middle Aged
  • Posterior Cerebral Artery / surgery*
  • Temporal Arteries / surgery*
  • Treatment Outcome
  • Vertebrobasilar Insufficiency / diagnostic imaging
  • Vertebrobasilar Insufficiency / physiopathology
  • Vertebrobasilar Insufficiency / surgery*