Usefulness of an ultrasonic scalpel to harvest and skeletonize the superficial temporal artery for extracranial-intracranial bypass surgery.
OBJECTIVE
A new method to harvest and skeletonize the superficial temporal artery (STA) using an ultrasonic scalpel is presented. The technique is simple and safe, and reduces bleeding. We also investigated histopathological changes in donor vessels and whether it is possible to shorten the time needed for STA harvesting using the ultrasonic scalpel.


METHODS
Between January 1, 2005, and December 31, 2007, 31 consecutive patients underwent STA and middle cerebral artery anastomosis surgery in our hospital. All patients underwent harvesting of both the frontal and parietal branches of the STA. STA harvesting using an ultrasonic scalpel was performed in 18 of the 31 patients. We compared the time needed for STA harvesting by dividing patients into 2 groups: a non-ultrasonic scalpel group and an ultrasonic scalpel group. We also examined the histopathological changes by application of ultrasonic waves on the STA in the 6 most recent patients.


RESULTS
The mean time needed for STA harvesting was 84.2 +/- 14.1 minutes for the non-ultrasonic scalpel group and 55.1 +/- 15.2 minutes for the ultrasonic scalpel group. The ultrasonic scalpel group showed a significantly shorter harvesting time than the non-ultrasonic scalpel group (P < 0.01). No histopathological change was observed in any layers of the STA.


CONCLUSIONS
Our data suggest that STA harvesting with the ultrasonic scalpel may be useful for STA-middle cerebral artery anastomosis surgery.
Wada
Kojiro
K
Department of Neurosurgery, Japan Defense Forces Central Hospital, Tokyo, Japan. mswokada@mishuku.gr.jp
Nawashiro
Hiroshi
H
Arimoto
Hirohiko
H
Ohkawa
Hidenori
H
Ono
Kenichiro
K
Takahara
Takashi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000295:instrumentation* / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000601:surgery; D002532:Intracranial Aneurysm / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D017063:Outcome Assessment, Health Care; D011300:Preoperative Care; D013525:Surgical Instruments; D013699:Temporal Arteries / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D020858:Tissue and Organ Harvesting; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation* / Q000379:methods*; D014463:Ultrasonography; D014654:Vascular Patency / Q000502:physiology; D055815:Young Adult