Alternative vascular graft for extracranial-intracranial bypass surgery: descending branch of the lateral circumflex femoral artery.
OBJECTIVE
Arterial bypass is an important method of treating intracranial disease requiring sacrifice of the parent vessel. The conduits for extracranial-intracranial (EC-IC) bypass surgery include the superficial temporal artery, occipital artery, superior thyroid artery, radial artery, and saphenous vein (long or short). In an aging population with an increased prevalence of vascular disease, conduits for EC-IC bypass may be in short supply in some patients. Herein, the authors describe a case in which the descending branch of the lateral circumflex femoral artery (DLCFA) was utilized as a high-flow conduit for an EC-IC bypass.


METHODS
This 22-year-old woman presented with irregular menstrual periods, secondary amenorrhea, and hypothyroidism. A giant intrasellar and suprasellar mass was found. Angiography confirmed a 3.5 x 2.1-cm fusiform aneurysm involving the cavernous and supraclinoid segments of the right internal carotid artery. A suitable radial artery conduit was not available. The DLCFA was harvested and anastomosed between the M(2) segment of the middle cerebral artery and the external carotid artery.


RESULTS
Durable clinical and angiographic results were apparent at the 2-month follow-up.


CONCLUSIONS
The DLCFA's diameter and length were used successfully in a high-flow EC-IC bypass surgery. The DLCFA may be a good alternative to radial artery and saphenous vein grafts for an EC-IC bypass requiring high flow.
Başkaya
Mustafa K
MK
Department of Neurological Surgery, University of Wisconsin, Madison, USA. m.baskaya@neurosurg.wisc.edu
Kiehn
Mark W
MW
Ahmed
Azam S
AS
Ateş
Ozkan
O
Niemann
David B
DB
D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal; D002548:Cerebral Revascularization / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D011859:Radiography