title: [Application of superficial temporal artery to middle cerebral artery bypass in treatment of cerebral artery steno-occlusive disease].
abstract: OBJECTIVE
  To explore the effect of superficial temporal artery to middle cerebral artery(STA-MCA) bypass in treatment of cerebrovascular disease.
  
  
  METHODS
  Fifty-two patients with atherosclerotic carotid artery occlusion or middle cerebral artery occlusion or moyamoya disease were included in this  study. There were both clinical ischemic manifestation and hemodynamic dysfunction detected by perfusion CT in all the patients. DSA and perfusion CT (PCT) were conducted before and after STA-MCA bypass in order to evaluate the change of hemodynamics and the state of anastomotic astium. The  patients were followed-up to know if there was any complication or recurrent stroke. Modified Rankin scale (mRS) was used in assessing the state of  neurological function.
  
  
  RESULTS
  STA-MCA bypass was performed successfully in 50 patients, while anastomotic astium was found to be obstructed in 2  patients during operation and temporalis attachment was conducted immediately. Complications occurred in 4 patients, 2 with subdural hematoma, 1 with  hematoma in contralateral basal ganglia, and 1 with poor wound healing. Postoperative DSA showed that anastomotic astium was opened well in 48  patients, while PCT displayed a significant improvement in both relative cerebral blood flow [rCBF,(37.79±9.76)mL/(min×100 g)vs.( 33.71±7.92)mL/(min×100  g),P<0.05] and the relative mean transmit time [rMTT,(8.49±1.97)s vs. (11.06±3.00)s,P<0.01]. mRS improved significantly in both the 3 month and 12  month follow-ups(1.37±0.66 vs. 1.58±0.64, 0.84±0.57 vs. 1.51±0.67,P<0.05). There was no ipsilateral stroke during the follow-up.
  
  
  CONCLUSIONS
  STA-MCA bypass may improve the hemodynamic and neurological condition and prevent the recurrence of ischemic stroke in patients combined with  occlusive cerebrovascular disease and hemodynamic disturbance.
authors: Department of Neurosurgery, Peking University First Hospital, Beijing, China.
authors: Hong-zhou
authors: HZ
authors: Duan
authors: Liang
authors: L
authors: Li
authors: Yang
authors: Y
authors: Zhang
authors: Da-peng
authors: DP
authors: Mo
authors: Zhi-qiang
authors: ZQ
authors: Yi
authors: Jia-yong
authors: JY
authors: Zhang
authors: Sheng-de
authors: SD
authors: Bao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000601:surgery; D002548:Cerebral Revascularization / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D013699:Temporal Arteries / Q000601:surgery*; D055815:Young Adult