title: Bypass of the maxillary to proximal middle cerebral artery or proximal posterior cerebral artery with radial artery graft.
abstract: The authors report three cases of radial artery (RA) graft bypass from the maxillary artery (MA) to either the middle cerebral artery (MCA) or the posterior cerebral artery (PCA). The first two cases presented with the features of basal ganglion ischemia, and magnetic resonance imaging (MRI) revealed left and right basal ganglion ischemia respectively, whereas angiogram showed MCA occlusion. Computed tomography angiography (CTA) of the third case, who presented with headache and dysphasia, showed a giant basilar artery aneurysm with an absence of the left posterior communicating artery (PComA). The first two cases underwent MA-MCA graft bypass and the third case underwent MA-posterior cerebral artery (PCA) RA graft bypass, followed by clipping of the left dominance vertebral artery and a sub-occipital decompressive craniotomy. Postoperative angiogram disclosed patent RA graft and refilling of the ischemic segment. Follow-up at 7-9 months showed marked clinical improvement in all cases. To our knowledge, MA bypass has not been performed clinically till the date and this method may be a safe, effective and new surgical technique for the extracranial-intracranial (EC-IC) bypass surgery.
authors.affiliation: Department of Neurosurgery, Beijing Sanbo Brain Hospital, No. 50 Yikesong Rd, Haidian District, Beijing 100093, China. shixen@sina.com
authors.forename: Xiang'en
authors.initials: X
authors.lastname: Shi
authors.forename: Hai
authors.initials: H
authors.lastname: Qian
authors.forename: K I Singh
authors.initials: KI
authors.lastname: K C
authors.forename: Yongli
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhongqing
authors.initials: Z
authors.lastname: Zhou
authors.forename: Yuming
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000328:Adult; D002548:Cerebral Revascularization / Q000379:methods*; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008438:Maxillary Artery / Q000601:surgery*; D008875:Middle Aged; D017534:Radial Artery / Q000637:transplantation*; D011859:Radiography; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000379:methods*