Internal thoracic artery to middle cerebral artery bypass surgery: cadaveric feasibility study.

Internal thoracic artery to middle cerebral artery bypass surgery: cadaveric feasibility study.

World Neurosurg. 2018 Jan 12;:

Authors: Monteith S, Goren O, Sampath R, Lehr E, Patel A, Choi PJ, Iwanaga J, Loukas M, Tubbs RS

Abstract
BACKGROUND: A few options of extracranial donor vessels exist for utilization in intracranial vascular bypass procedures. To our knowledge, the use of an internal thoracic artery for cerebral revascularization has not been studied previously. Hence, this cadaveric feasibility study was performed.
METHODS: The internal thoracic artery was dissected in five adult cadaveric specimens. The proximal diameter, distal diameter, and the length of the vessel were measured and recorded. The artery was, then, transected distally at the seventh intercostal space and transposed cranially, through a pterional craniotomy opening to reach the middle cerebral artery (MCA) at the skull base.
RESULTS: The mean diameter of the internal thoracic artery at its proximal end was 3.5 mm and at its distal end was 2 mm. The average length of the vessel was 31 cm. There was no statistical difference between the measurements recorded from different sides or sexes. In each specimen, an internal thoracic artery was dissected, rotated superiorly, and advanced subcutaneously behind the ear to reach the MCA at the skull base without difficulty and remained tensionless at the site of anastomosis.
CONCLUSION: In this cadaveric study, we demonstrated the suitability of the internal thoracic artery in use as a donor vessel for a single site anastomosis in a high-flow cerebral bypass procedure.

PMID: 29339321 [PubMed - as supplied by publisher]

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