title: Topographic Surgical Anatomy of the Parasylvian Anterior Temporal Artery for Intracranial-Intracranial Bypass.
abstract: BACKGROUND
  The anterior temporal artery (ATA) is an appealing donor artery for intracranial-intracranial bypass procedures. However, its identification may be difficult. Current literature lacks useful landmarks to help identify the ATA at the surface of the sylvian fissure. The objective of this study was to define the topographic anatomy of the cortical segment of the ATA relative to constant landmarks exposed during the pterional approach.
  
  
  METHODS
  The temporopolar artery (TPA), ATA, and middle temporal artery (MTA) were examined in 16 cadaveric specimens. The topographic anatomy and key landmarks of the arteries at the sylvian fissure were recorded. The distance between the point of emergence from the sylvian fissure to the lesser sphenoid wing and anterior tip of the temporal lobe was measured. The features of the inferior frontal gyrus relative to each of the arteries at the sylvian fissure were also recorded.
  
  
  RESULTS
  The average distances from the lesser sphenoid wing to the TPA, ATA, and MTA were 3.7 mm, 21.2 mm, and 37 mm. The mean distances from the temporal pole were TPA, 14.7 mm; ATA, 32.0 mm; and MTA, 45.4 mm. The differences between the average distances were statistically significant (P < 0.0001). The ATA most frequently faced pars triangularis, whereas the TPA always faced pars orbitalis. The MTA was always found posterior to the junction of pars triangularis and pars opercularis.
  
  
  CONCLUSIONS
  This article provides topographic evidence for efficient identification of the ATA in the parasylvian space. The key relationship and landmarks identified in this study may increase efficiency and safety when harvesting the ATA for intracranial-intracranial bypass.
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Ali Tayebi
authors.initials: AT
authors.lastname: Meybodi
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Dylan
authors.initials: D
authors.lastname: Griswold
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Halima
authors.initials: H
authors.lastname: Tabani
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Lawton
authors.affiliation: Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Pooneh
authors.initials: P
authors.lastname: Mokhtari
authors.affiliation: Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Andre
authors.initials: A
authors.lastname: Payman
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA; Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA. Electronic address: arnaubenet@gmail.com.
authors.forename: Arnau
authors.initials: A
authors.lastname: Benet
mesh_terms: D059925:Anatomic Landmarks / Q000033:anatomy & histology*; D002102:Cadaver; D002535:Cerebral Aqueduct / Q000033:anatomy & histology*; D002548:Cerebral Revascularization / Q000379:methods*; D006801:Humans; D008953:Models, Anatomic; D013699:Temporal Arteries / Q000033:anatomy & histology* / Q000637:transplantation*
keywords: Aneurysm; Intracranial-intracranial bypass; Middle cerebral artery; Revascularization; Sylvian fissure