Early Surgery-Related Complications after STA-MCA Anastomoses: Clinical Article

Kim, Dae Won; Kang, Sung Don

Abstract

OBJECTIVES
Extracranial-intracranial bypass has remained option of augmenting the cerebral circulation in patient with occlusive cerebrovascular disease, especially hemodynamic cerebral ischemia. The purpose of this article is to investigate early surgery-related complications and its prognosis after superficial temporal artery (STA)-middle cerebral artery (MCA) anastomoses.
METHODS
The study consists of a retrospective review of 47 patients who underwent 50 STA-MCA anastomoses performed by one surgeon for symptomatic occlusive cerebrovascular disease between 1996 and 2004. A surgical complication was determined on the basis of intraoperative findings, transcranial doppler examination, and radiological study.
RESULTS
A procedure-related surgical complication was diagnosed in 7 cases (14%). Complications included marked reduction of blood flow due to stretching of STA in 2, injury of STA in 1, obstruction of MCA angular branch due to incomplete suture in 2, thrombotic obstruction at the site of anastomosis in 1, and embolic obstruction at the site of anastomosis in 2 cases. Functional outcome was evaluated by Glasgow outcome scale.
CONCLUSIONS
To improve surgical performance, it is imperative to recognize all procedure-related complications, regardless of how minimal they may seem. We hope this will allow the patient to benefit the most from a procedure that has been proven effective in selected patients with hemodynamic cerebral ischemia.