title: Use of superior thyroid artery as a donor vessel in extracranial-intracranial revascularization procedures: a novel technique.
abstract: Objective To describe the use of the superior thyroid artery as a donor vessel in extracranial-intracranial (EC-IC) revascularization when a "low-flow" bypass is required and the superficial temporal artery is not available. Design Case report. Setting University hospital. Participants Four cases. Main Outcome Measures Postoperative course after EC-IC bypass surgery. Results In case 1, the parent vessel was occluded postoperatively. The radial bypass was sufficient to replace the internal carotid artery (ICA) flow, and a prophylactic was turned into a definitive bypass. In case 2, the superior thyroid artery was used because the radial artery was not long enough to reach the external carotid artery. The recipient vessel was modified from the middle cerebral artery to the ophthalmic segment of the ICA. In case 3, the graft was occluded after surgery because of carotid artery reconstruction. In case 4, after surgery/radiotherapy for meningioma, the patient developed wound dehiscence and was reoperated for bypass occlusion. The graft was weak and bled intraoperatively, without infarction. The three first patients are intact, and the fourth remains disabled (Glasgow Outcome Scale: 3; Rankin Scale: 5). Conclusion The superior thyroid artery was adequate for proximal anastomosis in EC-IC procedures in the situations described.
authors.affiliation: Department of Cerebrovascular and Skull Base Surgery, Institute of Neurosurgery Asenjo, Providencia, Santiago, Chile ; Department of Neurological Sciences, School of Medicine, University of Chile, Santiago, Chile.
authors.forename: Jorge
authors.initials: J
authors.lastname: Mura
authors.affiliation: Department of Cerebrovascular and Skull Base Surgery, Institute of Neurosurgery Asenjo, Providencia, Santiago, Chile ; Department of Neurological Sciences, School of Medicine, University of Chile, Santiago, Chile.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Cuevas
authors.affiliation: Department of Cerebrovascular and Skull Base Surgery, Institute of Neurosurgery Asenjo, Providencia, Santiago, Chile.
authors.forename: Francisco
authors.initials: F
authors.lastname: Riquelme
authors.affiliation: Department of Cerebrovascular and Skull Base Surgery, Institute of Neurosurgery Asenjo, Providencia, Santiago, Chile.
authors.forename: Esteban
authors.initials: E
authors.lastname: Torche
authors.affiliation: Department of Vascular Surgery, Salvador Hospital, Santiago, Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Julio
authors.affiliation: Department of Cerebrovascular and Skull Base Surgery, Sustainable Health NGO, São Leopoldo, RS, Brazil ; Department of Cerebrovascular and Skull Base Surgery, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil ; Department of Cerebrovascular and Skull Base Surgery, Skull Base and Brain Tumor Center, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil.
authors.forename: Gustavo Rassier
authors.initials: GR
authors.lastname: Isolan
keywords: EC-IC arterial bypass; brain/blood supply; cerebral revascularization; operative; surgical procedures