J Korean Neurosurg Soc.  2009 Nov;46(5):488-491. 10.3340/jkns.2009.46.5.488.

External Carotid Artery Angioplasty and Stenting Followed by Superficial Temporal Artery to Middle Cerebral Artery Anastomosis

• Ko JK
• Lee SW
• Lee TH
• Choi CH

• KMID: 2190081
• DOI: http://doi.org/10.3340/jkns.2009.46.5.488

Abstract

A 31-year-old man presented with right hemiparesis, and magnetic resonance imaging revealed a small infarct at left basal ganglia. Digital subtraction angiography showed left cervical internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA) with collateral cerebral circulation fed by ECAs. Based on the results of a functional evaluation of cerebral blood flow, we performed preventive ECA angioplasty and stenting for advanced ECA stenosis to ensure sufficient blood flow to the superficial temporal artery. Eight weeks later, superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed. His postoperative course was uneventful and no additional transient ischemic attacks have occurred. To our knowledge, this is the first report of preventive angioplasty and stenting for advanced narrowing of an ECA before STA-MCA anastomosis for ipsilateral ICA occlusion.

Keyword

Angioplasty; External carotid artery; Internal carotid artery; Middle cerebral artery

MeSH Terms

Adult
Angiography, Digital Subtraction
Angioplasty
Basal Ganglia
Carotid Artery, External
Carotid Artery, Internal
Constriction, Pathologic
Dietary Sucrose
Humans
Ischemic Attack, Transient
Magnetic Resonance Imaging
Middle Cerebral Artery
Paresis
Stents
Temporal Arteries
Dietary Sucrose