Introduction: The ultrasonic scalpel (Harmonic Scalpel; Ethicon, CO) can peel arteries from collagen-poor tissues, including adipose tissue, without damage to the arteries themselves. This procedure has been applied to skeletonization such as of an internal thoracic artery in the field of cardiac surgery and has become widespread. We have recently performed harvesting of the superficial temporal artery (STA) using an ultrasonic scalpel for bypass surgery, but reports of such procedures in the neurosurgical field has been rare. We herein investigated histological changes to the STA for safety assessment.
Material and Method: Bypass surgery was performed in 15 consecutive patients (mean age, 62 years; range, 34-80 years; atheroma, n=10; moyamoya disease, n=3; arterial dissection, n=2) from January 2012 to February 2014. Twenty-two STA specimens were peeled using the ultrasonic scalpel and evaluated histologically.
Results: Degeneration of the vascular wall was found in adventitia to media in 1 specimen (5%), and adventitia alone in 4 specimens (18%). No specimens showed intimal degeneration (0%).
Conclusion: STA harvesting by ultrasonic scalpel can be performed safely, although thermal injury was histologically evident in 23% of the 15 cases (22 specimens) examined. Some mastery of skills is needed for further safety.
