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ORIGINAL ARTICLE
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Efficacy of superficial temporal artery-middle cerebral artery bypass in cerebrovascular steno-occlusive diseases: Hemodynamics assessed by perfusion computed tomography


1 Department of Neurosurgery, Korea University, Guro Hospital, Korea University College of Medicine, Seoul, Korea
2 Department of Neurosurgery, Korea University, Anam Hospital, Korea University College of Medicine, Seoul, Korea
3 Department of Neurosurgery, Korea University, Ansan Hospital, Korea University College of Medicine, Ansan, Korea

Correspondence Address:
Taek-Hyun Kwon,
80, Guro dong, Guro gu, Seoul 152 703
Korea
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Source of Support: None, Conflict of Interest: None

Objectives: Our purpose of this study was to assess the cerebral hemodynamic improvement with perfusion computed tomography (CT), before and after superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery in patients with cerebrovascular steno-occlusive diseases including both moyamoya disease and nonmoyamoya steno-occlusions. Materials and Methods: Twenty-four STA-MCA bypasses were performed to 22 patients with symptomatic cerebrovascular steno-occlusive diseases, including both moyamoya disease and nonmoyamoya steno-occlusive diseases. Brain perfusion CT images were obtained before and after the bypass surgery. The relative parameters such as cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) derived from the perfusion CT were collected and analyzed to assess the efficacy of STA-MCA bypass. Results: The CBF increased, and MTT decreased after the bypass surgery in both moyamoya group and nonmoyamoya group. The increase of CBF in nonmoyamoya group and the decrease of MTT delay in moyamoya group, overall group were statistically significant (P < 0.05). No significant postoperative change in CBV was noted. During the postoperative follow-up period, none of the 22 patients experienced any repeated ischemic/hemorrhagic attacks nor any newly developed neurologic deficits. Conclusion: The STA-MCA bypass is an effective surgical management for patients with cerebrovascular steno-occlusive diseases, such as moyamoya disease and internal carotid artery/MCA steno-occlusion. And perfusion CT can be used as an effective quantitative modality to assess the cerebral perfusion before and after the STA-MCA bypass surgery.


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    -  Kwon WK
    -  Kwon TH
    -  Park DH
    -  Kim JH
    -  Ha SK
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