A 1-Donor 2-Recipient Superficial Temporal Artery-Middle Cerebral Artery Bypass for Moyamoya Syndrome: 2-Dimensional Operative Video

Nickalus R. Khan, Jacques J. Morcos

Research output: Contribution to journalArticlepeer-review

Abstract

We present the case of a 34-yr-old male who suffered repeated ischemic events resulting in right-sided weakness. He was found to have left M1 segment near occlusion on angiography with a large area of uncompensated hypoperfusion. The patient underwent a direct superficial temporal artery-middle cerebral artery (STA-MCA) bypass. Direct bypass in the acute setting of ischemia has been previously described.1-5 Moyamoya ischemic disease can be treated with either direct or indirect surgical revascularization. There have been several techniques developed for direct bypasses in moyamoya ischemic disease. These include the standard 1-donor 1-recipient (1D1R) end-to-side (ES) bypass, the "double-barrel" 2-donor 2-recipient (2D2R) ES bypass, and the more recently developed 1-donor 2-recipient (1D2R)6,7 utilizing both an ES and a side-to-side (SS) bypass with a 1-donor vessel. The case presentation, surgical anatomy, decision-making, operative nuances, and postoperative course and outcome are reviewed. The patient gave verbal consent for participating in the procedure and surgical video.

Original languageEnglish (US)
Pages (from-to)E437
JournalOperative neurosurgery (Hagerstown, Md.)
Volume20
Issue number6
DOIs
StatePublished - May 13 2021

Keywords

  • 1D2R
  • Bypass
  • Direct
  • Ischemia
  • Moyamoya
  • STA-MCA

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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