Maxillary artery to middle cerebral artery bypass for treatment of ischemic cerebrovascular disease

Abstract

Objective To report a new method of the internal maxillary artery(MA)-radial artery (RA)-proximal middle cerebral artery (MCA) bypass surgery for the treatment of ischemic cerebrovascular disease and evaluate the efficacy of the bypass.Methods The clinical data of 10 patients with ischemic cerebrovascular disease were analyzed retrospectively.The new bypass surgery was performed in all cases.Based on the improvement of postoperative clinical symptoms and the changes of the preoperative and postoperative imaging examinations,the safety and efficacy of the new operation were assessed.Results In ten patients,eight MA-RA-MCA bypasses were patent on postoperative CTA and/or DSA.TCD demonstrated a patent anastomosis in one female patient and CTA also revealed this point at her 3-month follow-up.Whether the bypass was patent or not was not clear in one patient because he didn't receive relative examination postoperatively.The ten cases were followed-up with duration from 4 months to 16months (mean,10.3 months).The clinical symptoms of the other 9 patients were upgraded in various degrees except one patient who was dead at the 4th postoperative month.There was no postoperative graft harvest complication.Conclusions The MA-MCA bypass surgery in patients with ischemic cerebrovascular diseases is safe and effective.The bypass could supply high blood flow volume and its bypass path is shorter than other bypass techniques.The long-term efficacy of the bypass should to be further observed and studied. Key words: Bypass ; Internal maxillary artery; Middle cerebral artery ; Ischemic cerebrovascular disease