Extracranial‐intracranial arterial bypass

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Abstract
To date, published experience indicates that the superficial temporal artery-middle cerebral artery (STA-MCA) bypass operation is being performed by neurosurgeons at a number of large medical centers, with mortality ranging from 0-3% and persistent stroke morbidity ranging from 0-1%, but other patients have had transient focal neurologic deficits after this surgery. In spite of the apparent technical success of anastomosis of the superficial temporal artery to the middle cerebral artery, the indications for this procedure are not adequately defined. It is advocated in: patients with occlusion of the internal carotid artery; patients with stenosis of the internal carotid artery that is inaccessible to the surgeon; and patients with occlusion or stenosis of the middle cerebral artery. These indications are discussed.

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