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Superficial Temporal Artery Dissection: A Technical Note

Schirmer, Clemens M. MD, PhD*,‡,§; David, Carlos A. MD‡,§

doi: 10.1227/NEU.0b013e318273a5f2
Operative Technique

BACKGROUND: Dissection of the superficial temporal artery (STA) is often required in preparation for a bypass procedure. Traditionally, dissection of the STA involves a direct cutdown on the artery after marking the course of the artery on the skin with the help of a Doppler ultrasound probe.

OBJECTIVE: We describe a method that takes advantage of the position of the STA superficial to the temporal fascia.

METHODS: The technique was used in a total of 38 procedures in 32 patients to create synangiosis or extracranial-intracranial STA bypasses. The STA was dissected using a blunt malleable brain retractor that was inserted into the subgaleal plane directly over the STA, allowing creation of a linear incision and concurrent protection of the STA in its bed. Either computed tomography– or catheter-based angiography was used to evaluate the patency postoperatively.

RESULTS: All STA vessels were dissected without complications or injury to the graft vessel. The sole complication was a superficial wound breakdown in a synangiosis case. Postoperative angiography demonstrated patency in all but 1 of the 24 bypass cases (95.8%).

CONCLUSION: We describe a method that takes advantage of the position of the STA superficial to the temporal fascia to allow rapid, safe, and efficacious dissection. The incision is linear and easier to manage and close. In our series, there were no technical complications related to the dissection of the STA.

ABBREVIATIONS: EC-IC, extracranial-intracranial

STA, superficial temporal artery

*Division of Neurosurgery, Baystate Medical Center, Springfield, Massachusetts

Department of Neurosurgery, Lahey Clinic, Burlington, Massachusetts

§Department of Neurosurgery, Tufts University School of Medicine, Boston, Massachusetts

Correspondence: Carlos A. David, MD, Department of Neurosurgery, Lahey Clinic, 41 Mall Road, Burlington, MA 01803. E-mail: Carlos.David@lahey.org

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Received May 20, 2012

Accepted August 16, 2012

Copyright © by the Congress of Neurological Surgeons