title: Signal reduction of donor artery on MRI after superficial temporal artery to middle cerebral artery anastomosis: a retrospective analysis.
abstract: OBJECTIVE
  Microsurgical anastomosis from the superficial temporal artery (STA) to the middle cerebral artery (MCA) is a treatment option for appropriately selected patients with cranial atherosclerotic steno-occlusive disease (CASD). However, the long-term efficacy and patency of the donor artery remain unclear. We reviewed the signal intensity of the donor artery on magnetic resonance angiography (MRA) after STA-MCA anastomosis in patients with CASD and clarified the incidence of and risk factors for reduction in postoperative signal of STA.
  
  
  METHODS
  From April 2007 to March 2015, 155 STA-MCA anastomosis operations for CASD were performed at our institute. The postoperative imaging findings of 112 patients with available follow-up data for more than 3 months were retrospectively reviewed.
  
  
  RESULTS
  Over a median follow-up of 24 months, the signal of the donor artery on MRA became weaker than that on MRA performed immediately after surgery in 30 (27%) patients. The rates of signal reduction at 1 and 2 years after surgery were 18 and 25%, respectively. Multivariate analysis revealed that a high STA bifurcation (p = 0.015; odds ratio, 7.14) and the presence of chronic kidney disease (p = 0.011; odds ratio, 5.59) were independent risk factors for postoperative signal reduction.
  
  
  CONCLUSIONS
  Our results suggest that the signal intensity of the donor artery of an established STA-MCA bypass decreases in many cases. Both the loose entrance of the STA to the dura and systemic atherosclerosis are related to postoperative vessel remodeling.
authors.affiliation: Department of Neurosurgery, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan.|Department of Neurosurgery, The University of Tokyo, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Koizumi
authors.affiliation: Department of Neurosurgery, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan. tkim-tky@umin.ac.jp.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Neurosurgery, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D013699:Temporal Arteries / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Anastomosis; Complication; Follow-up; Middle cerebral artery; Superficial temporal artery