ArticleActa neurochirurgica2026
Superficial temporal artery-to-middle cerebral artery side-to-side microvascular anastomosis and cranioplasty in a single-stage procedure: Technical nuances and hemodynamic outcomes.
Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCranioplasty following decompressive craniectomy in patients requiring concurrent cerebral revascularization presents a surgical challenge. While traditional end-to-side bypass may compromise scalp perfusion, a combined single-stage procedure integrating extracranial-to-intracranial (EC-IC) bypass with cranioplasty offers a potential strategy for consolidating treatment, reducing cumulative procedural risks, and optimizing recovery.
objectiveTo assess the feasibility of a single-stage procedure integrating superficial temporal artery (STA)-middle cerebral artery (MCA) side-to-side (S-S) anastomosis with cranioplasty and analyze the postoperative hemodynamic flow distribution.
resultsTwo patients successfully underwent single-stage STA-MCA S-S microvascular anastomosis with cranioplasty. Good patency of the STA-MCA S-S anastomosis was confirmed by both intraoperative indocyanine green videoangiography (ICG-VA) and postoperative digital subtraction angiography (DSA). On the postoperative DSA, a similar hemodynamic blood flow pattern was observed in both patients, and the proximal STA provided antegrade blood flow to the recipient MCA and the distal STA. No postoperative complications, including cerebral infarction, cerebral hyperperfusion syndrome, or wound healing issues, were observed.
conclusionsA single-stage combined S-S EC-IC anastomosis and cranioplasty procedure offers a viable, safe, and effective surgical strategy for patients requiring EC-IC revascularization and cranioplasty after craniectomy.
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