Endovascular stenting for rescue of a failed donor graft during superficial temporal artery to middle cerebral artery bypass surgery: Case report

Melissa A. LoPresti, Visish M. Srinivasan, Robert Y. North, Vijay M. Ravindra, Jeremiah Johnson, Jan Karl Burkhardt, Sandi K. Lam, Peter Kan

Research output: Contribution to journalArticle

Abstract

The authors report the case of a 7-year-old patient who underwent a superficial temporal artery to middle cerebral artery (STA-MCA) bypass for treatment of a giant MCA aneurysm and describe the role of endovascular rescue in this case. Post-bypass catheter angiogram showed occlusion of the proximal extracranial STA donor with patent anastomosis, possibly due to STA dissection. A self-expanding Neuroform Atlas stent was deployed across the dissection flap, and follow-up images showed revascularization of the STA with good MCA runoff. This case demonstrates that direct extracranial-intracranial bypass failure can infrequently originate from the STA donor vessel and that superselective angiogram can be useful for identification and treatment in such cases. With more advanced endovascular techniques the tide has turned in the treatment of complex cerebrovascular cases, with this case being an early example of successful rescue stenting for endovascular management of a failed donor after STA-MCA bypass.

Original languageEnglish (US)
Pages (from-to)572-576
Number of pages5
JournalJournal of Neurosurgery: Pediatrics
Volume24
Issue number5
DOIs
StatePublished - 2019
Externally publishedYes

Keywords

  • Aneurysm
  • Bypass
  • Endovascular treatment
  • IC-EC
  • Pediatrics
  • STA-MCA
  • Stent
  • Vascular disorders

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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