title: Dissection of both frontal and parietal branches of the superficial temporal artery for bypass surgery through a single linear skin incision.
abstract: BACKGROUND
  Double superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery has typically involved more than one linear incision. In this report, we demonstrate how the procedure can be performed through a single linear skin incision over the parietal branch of the STA.
  
  
  METHODS
  Initial dissection of the parietal branch and creation of a subcutaneous cavity along the frontal branch were performed using the conventional microscopic method. Detailed additional dissection and isolation of the frontal branch were accomplished with the aid of an endoscopic retractor.
  
  
  RESULTS
  This procedure was performed in five patients for harvesting of approximately 8- and 5-cm lengths of the parietal and frontal branches, respectively. The resultant lengths of the harvested vessels were sufficient for anastomotic revascularization of MCA recipient arteries in both the frontal and temporal lobes.
  
  
  CONCLUSIONS
  This method can be safely performed with achievement of a less invasive dissection of the STA and an overall improved cosmetic outcome.
authors.affiliation: Department of Neurosurgery, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan. neu034@poh.osaka-med.ac.jp
authors.forename: Yoji
authors.initials: Y
authors.lastname: Tamura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Aoki
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yamada
authors.forename: Naosuke
authors.initials: N
authors.lastname: Nonoguchi
authors.forename: Ryokichi
authors.initials: R
authors.lastname: Yagi
authors.forename: Adam
authors.initials: A
authors.lastname: Tucker
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kuroiwa
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002548:Cerebral Revascularization / Q000379:methods*; D004210:Dissection / Q000379:methods*; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply* / Q000601:surgery; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery*; D013699:Temporal Arteries / Q000601:surgery*; D013702:Temporal Lobe / Q000098:blood supply* / Q000601:surgery; D016896:Treatment Outcome