1
|
Oliveira LB, Cieslak PH, Ferreira MY, Fuziki CK, Martins IC, Semione G, Marques GN, Palavani LB, Batista S, Rabelo NN, Koester SW, Bertani R, Welling LC, Lawton MT, Figueiredo EG. STA-MCA Double-Barrel Bypass: A Systematic Review of Technique and Single-Arm Meta-Analysis of Outcomes. Neurosurg Rev 2024; 47:341. [PMID: 39030432 DOI: 10.1007/s10143-024-02520-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/10/2024] [Accepted: 06/15/2024] [Indexed: 07/21/2024]
Abstract
INTRODUCTION Conventionally, one branch of the superficial temporal artery (STA) is utilized to revascularize the middle cerebral artery (MCA). However, there is the possibility of utilizing both branches of the STA when performing the bypass, characterizing the double-barrel (DB) STA-MCA bypass. Notably, a lack of studies evaluating this technique led the authors to conduct a systematic review and single-arm meta-analysis. METHODS PubMed, Embase and Web of Science were searched systematically for publications of DB-STA-MCA bypass on November 1st, 2023. The findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Case reports were not included for statistical analysis purposes. RESULTS The review included 408 patients and 534 bypasses from 34 studies. The main etiology was Moyamoya disease (64.6%), followed by cerebral ischemia (22.2%) and aneurysms (12.5%). The median of the mean follow-ups of each study was 12.8 months (range 1.5-87.9). The postoperative patency was 100%. The follow-up patency was 98% (95% CI: 96%-100%; I2 = 0%). The procedure-related mortality was 0% (95% CI: 0%-1%; I2 = 0%). Aneurysms obtained 87% (95% CI: 72%-100%; I2 = 4%) of good clinical outcomes, while Moyamoya disease yielded a rate of 70% (95% CI: 10%-100%; I2 = 97%). Ischemic complications occurred at a rate of 6% (95% CI: 2%-11%; I2 = 36%), while hemorrhagic occurred at 6% (95% CI: 1%-11%; I2 = 56%). Hyperperfusion syndrome rate was calculated as 18% (7%-30%; I2 = 55%) for Moyamoya disease. CONCLUSIONS The procedure appears to be safe, with excellent patency rates. The clinical efficacy for ischemic and Moyamoya diseases warrants further standardized robust investigation with a broader number of patients, and aneurysm studies are required to enhance sample sizes. The main complication for the Moyamoya subgroup is hyperperfusion syndrome.
Collapse
Affiliation(s)
- Leonardo B Oliveira
- Department of Neurosurgery, State University of Ponta Grossa, Ponta Grossa, PR, Brazil.
| | | | | | - Cassiano K Fuziki
- Department of Neurosurgery, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Italo C Martins
- Department of Neurosurgery, Federal University of Maranhão, São Luís, MA, Brazil
| | - Gabriel Semione
- Department of Neurosurgery, University of West of Santa Catarina, Joaçaba, SP, Brazil
| | | | - Lucca B Palavani
- Department of Neurosurgery, Max Planck University Center, Indaiatuba, SP, Brazil
| | - Sávio Batista
- Department of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Stefan W Koester
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Raphael Bertani
- Department of Neurosurgery, University of São Paulo, São Paulo, SP, Brazil
| | - Leonardo C Welling
- Department of Neurosurgery, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA
| | | |
Collapse
|
2
|
Shimoi A, Tsunoda S, Inoue T, Akabane A. Efficacy of Emergent STA–MCA Bypass for Acute Atherosclerotic ICA Stenosis/Occlusion with Concomitant Chronic Contralateral ICA Occlusion/Stenosis: Two Case Reports. Asian J Neurosurg 2022; 17:324-330. [PMID: 36176923 PMCID: PMC9514952 DOI: 10.1055/s-0042-1750306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Recombinant tissue-type plasminogen activator with/without endovascular regimen is sometimes not effective for the treatment of acute hemodynamic stroke. Emergent superficial temporal artery-middle cerebral artery (STA–MCA) bypass has been reportedly effective in patients with progressive hemodynamic stroke; however, the effectiveness of urgent STA–MCA bypass for acute internal carotid artery (ICA) stenosis/occlusion with concomitant contralateral chronic ICA stenosis/occlusion, that is considered the worst hemodynamic situations, is unclear. Two cases of acute left ICA stenosis with concomitant right chronic ICA occlusion wherein both developed hemodynamic infarction and were initially treated by maximal medical treatment. Nevertheless, the patients' symptoms had gradually worsened, thus we performed emergency STA–MCA bypass for both cases. Postoperatively, deterioration of imaging and neurological findings was successfully stopped and the patients' condition gradually stabilized. An urgent STA–MCA bypass can be considered as a last resort to prevent progressive neurological deterioration for patients with progressive infarction due to ICA stenosis/occlusion concomitant with contralateral ICA stenosis/occlusion.
Collapse
Affiliation(s)
- Akihiro Shimoi
- Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan
| | - Sho Tsunoda
- Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan
| | - Tomohiro Inoue
- Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan
| | - Atsuya Akabane
- Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan
| |
Collapse
|
3
|
Guida L, Sebök M, Wegener S, Fierstra J, van Niftrik B, Luft AR, Regli L, Esposito G. Flow-augmentation bypass in the treatment of acute ischemic stroke. J Neurosurg Sci 2020; 65:269-276. [PMID: 33297606 DOI: 10.23736/s0390-5616.20.05110-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Results of two randomized trials did not show benefit of revascularization with extracranial-intracranial (EC-IC) flow augmentation bypass in patients with symptomatic occlusion of internal carotid artery (ICA). However, patients with acute stroke were not included in these studies. Herein, we systematically analyze and discuss the literature about flow augmentation bypass for treatment of acute ischemic stroke. EVIDENCE ACQUISITION This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. MEDLINE, Web of Science and EMBASE were independently searched by two reviewers for published series to identify literature relating to EC-IC bypass in the surgical management of acute ischemic stroke up to June 2020. Studies were categorized according to their level of evidence. EVIDENCE SYNTHESIS Nineteen studies met the inclusion criteria for the systematic literature review, including 16 level IV studies (ten case series and six6 case reports) and three level III studies (retrospective cohort case-control studies). Occurrence of fatal or non-fatal ischemic or hemorrhagic postoperative stroke, as well as clinical functional outcome at follow-up were considered as primary and secondary endpoints, respectively. CONCLUSIONS The literature about flow augmentation bypass for treatment of acute ischemic stroke is scarce and heterogenous, with only 19 studies. The results of the present systematic review encourage further study to explore and validate the use of EC-IC bypass in the treatment of anterior circulation acute ischemic stroke in highly selected patients (symptomatic and with persistent penumbra despite best medical/endovascular treatment).
Collapse
Affiliation(s)
- Lelio Guida
- Department of Neurosurgery, Zurich University Hospital, Clinical Neuroscience Center, Zurich, Switzerland.,Department of Neurosurgery, University of Milan, Milan, Italy
| | - Martina Sebök
- Department of Neurosurgery, Zurich University Hospital, Clinical Neuroscience Center, Zurich, Switzerland
| | - Susanne Wegener
- Department of Neurology, Zurich University Hospital, Clinical Neuroscience Center, Zurich, Switzerland
| | - Jorn Fierstra
- Department of Neurosurgery, Zurich University Hospital, Clinical Neuroscience Center, Zurich, Switzerland
| | - Bas van Niftrik
- Department of Neurosurgery, Zurich University Hospital, Clinical Neuroscience Center, Zurich, Switzerland
| | - Andreas R Luft
- Department of Neurology, Zurich University Hospital, Clinical Neuroscience Center, Zurich, Switzerland.,Cereneo Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - Luca Regli
- Department of Neurosurgery, Zurich University Hospital, Clinical Neuroscience Center, Zurich, Switzerland
| | - Giuseppe Esposito
- Department of Neurosurgery, Zurich University Hospital, Clinical Neuroscience Center, Zurich, Switzerland -
| |
Collapse
|
4
|
Single-Barrel Versus Double-Barrel Superficial Temporal Artery to Middle Cerebral Artery Bypass: A Comparative Analysis. World Neurosurg 2019; 125:e408-e415. [DOI: 10.1016/j.wneu.2019.01.089] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 01/05/2019] [Accepted: 01/08/2019] [Indexed: 11/17/2022]
|
5
|
Kanematsu R, Kimura T, Ichikawa Y, Inoue T. Safety of urgent STA-MCA anastomosis after intravenous rt-PA treatment: a report of five cases and literature review. Acta Neurochir (Wien) 2018; 160:1721-1727. [PMID: 29869110 DOI: 10.1007/s00701-018-3576-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 05/23/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Intravenous recombinant tissue-type plasminogen activator (rt-PA) with/without endovascular treatment is not as effective in atherosclerotic steno-occlusive acute ischemic stroke. Urgent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is effective to some extent in progressing stroke, but the safety of STA-MCA anastomosis soon after rt-PA therapy is unknown. Our aim was to clarify the safety of STA-MCA anastomosis within 24 h after intravenous rt-PA. METHOD From 2005 to 2015, rt-PA was administered to 225 patients presenting with acute ischemic stroke according to the Japanese Stroke Guidelines, in our institution. Five patients underwent urgent STA-MCA anastomosis after rt-PA administration with or without endovascular recanalization. Clinical time course, surgical complications, and patients' prognosis were investigated. RESULTS The average of patient age was 65.4 years (range 49-77 years); three patients had internal carotid artery occlusion, and two patients had middle cerebral artery occlusion. The median National Institutes of Health Stroke Scale score on admission was 12.4 (range 6-17 points) and operation occurred 10.6 h (range 5.3-23.6 h) after intravenous rt-PA administration. Hemostasis was achieved during standard STA-MCA anastomosis, and there were no hemorrhagic complications. CONCLUSIONS In our consecutive cases, urgent STA-MCA anastomosis after at least 5.3 h after intravenous rt-PA was performed safely without hemorrhagic complications.
Collapse
Affiliation(s)
- Ryo Kanematsu
- Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan
| | - Toshikazu Kimura
- Department of Neurosurgery, Japanese Red Cross Medical Center, Hiroo 4-1-22 Shibuya, Tokyo, 150-0012, Japan.
| | | | - Tomohiro Inoue
- Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan
| |
Collapse
|
6
|
Choi YH, Park HS, Kang MJ, Cha JK. Revision Superficial Temporal Artery-Middle Cerebral Artery Bypass Surgery for Recurrent Acute Ischemic Stroke Due to Delayed Occlusion of the Bypass Graft. J Cerebrovasc Endovasc Neurosurg 2018; 20:127-132. [PMID: 30370247 PMCID: PMC6196140 DOI: 10.7461/jcen.2018.20.2.127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 01/20/2018] [Accepted: 05/01/2018] [Indexed: 11/23/2022] Open
Abstract
Intravenous thrombolysis (IVT) and endovascular treatment (EVT) are currently the main treatments for reperfusion in acute ischemic stroke. Although the EVT recanalization rate has increased, unsuccessful recanalization is still observed in 10-30% cases. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass is considered a rescue therapy in such cases, but in most centers it is not usually performed for acute ischemic stroke. Graft occlusion is rare following STA-MCA bypass, but it might lead to recurrent ischemic stroke. We hereby report on a patient with right MCA infarction and in whom EVT failed due to complete proximal internal carotid artery occlusion. He underwent an emergency STA-MCA bypass, resulting in a full recovery of his motor weakness. However, six months later, the patient experienced recurrent acute ischemic stroke due to bypass graft occlusion. His EVT failed again but revision bypass surgery, using STA remnant branch, was successful with full motor weakness recovery. We recommend a revision bypass surgery as a feasible therapeutic option for recurrent cerebral infarction caused by delayed STA graft occlusion.
Collapse
Affiliation(s)
- Yun-Hee Choi
- Department of Neurosurgery, Busan-Ulsan Regional Cardio-Cerebrovascular Center, Dong-A University College of Medicine, Busan, Korea
| | - Hyun-Seok Park
- Department of Neurosurgery, Busan-Ulsan Regional Cardio-Cerebrovascular Center, Dong-A University College of Medicine, Busan, Korea
| | - Myong-Jin Kang
- Department of Radiology, Busan-Ulsan Regional Cardio-cerebrovascular Center, Dong-A University College of Medicine, Busan, Korea
| | - Jae-Kwan Cha
- Department of Neurology, Busan-Ulsan Regional Cardio-cerebrovascular Center, Dong-A University College of Medicine, Busan, Korea
| |
Collapse
|