• World Neurosurg · Aug 2022

    One-stage Revascularization to the Ipsilateral Middle Cerebral Artery and Contralateral Anterior Cerebral Artery Territories.

    • Sho Tsunoda, Tomohiro Inoue, Masafumi Segawa, and Atsuya Akabane.
    • Department of Neurosurgery, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan. Electronic address: s.tsunoda1024@gmail.com.
    • World Neurosurg. 2022 Aug 1; 164: 128-134.

    BackgroundPatients with multiple intracranial atherosclerotic stenoses often present with hemodynamic instability in 2 remote regions without a reciprocal vascular network. In this situation, revascularization to each region may be required.MethodsIn this report, 2 patients who had coexisting unilateral middle cerebral artery (MCA) and contralateral anterior cerebral artery territory ischemia were treated by using ipsilateral superficial temporal artery (STA)-radial artery graft-contralateral A3 bypass and ipsilateral STA-MCA bypass in one stage.ResultsPostoperatively, the bypass conduit was well established, and the patients' hemodynamic instability was improved.ConclusionsIn patients with severe hemodynamic instability in the remote unilateral MCA and contralateral anterior cerebral artery regions, as in our 2 cases, ipsilateral STA-MCA and ipsilateral STA-radial artery graft-contralateral A3 bypasses in one stage can be a treatment option.Copyright © 2022 Elsevier Inc. All rights reserved.

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