Abstract
The long-term effects of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis on regional cerebral blood flow (rCBF) were evaluated in 54 patients with ischemic cerebrovascular disease who were operated on in the chronic stage. rCBF was measured by the Xe-133 inhalation method using initial slope index. The mean follow-up period was 26 months. In cases of major artery occlusion without infarction in the cortex, mean hemispheric CBF (mCBF) in the affected side increased and laterality (the difference in mCBF between the hemispheres) was reduced significantly 3 months after surgery. The improvement in mCBF was sustained for up to 3 years. In cases of major artery occlusion with infarction in the cortex, mCBF did not increase but laterality decreased soon after surgery and the reduction was sustained for a long period. In patients with major artery stenosis, mCBF decreased significantly within 3 months of surgery and then increased gradually, eventually approaching the preoperative levels. Laterality was unchanged. These observations indicate that, in selected cases, STA-MCA anastomosis confers long-term hemodynamic improvement in patients with ischemic cerebrovascular disease.
