Trans-sylvian Superficial Temporal Artery-Superior Cerebellar Artery Bypass: Procedure Development and Case Reports

Abstract

We have developed a new superficial temporal artery (STA)-superior cerebellar artery (SCA) bypass procedure via the trans-sylvian approach that can provide wider surgical space than that in routine STA-SCA bypass via the subtemporal approach, which could be associated with technical difficulties when performing deep and narrow microvascular anastomoses. Our method utilizes the combined pterional/anterior temporal approach and tentorial edge resection. Anastomosis is performed at the anterior pontomesencephalic segment of the SCA just lateral to the oculomotor nerve. We report and illustrate two cases that we encountered in our preliminary clinical experience in order to demonstrate the development and techniques of the procedure.