Superficial temporal artery to middle cerebral artery anastomosis. Intraoperative evaluation by fluorescein angiography and xenon-133 clearance

Journal Article · Tue May 01 04:00:00 EDT 1979 · J. Neurosurg.; (United States)

DOI:https://doi.org/10.3171/jns.1979.50.5.0560· OSTI ID:6689729

Little, J R; Yamamoto, Y L; Feindel, W; Meyer, E; Hodge, C P

Fluorescein angiography and xenon-133 (/sup 133/Xe) clearance studies were performed during surgery on 15 patients who were undergoing superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis. Fourteen patients had occlusive disease of the internal carotid artery (ICA), and one patient had severe stenosis of the MCA. Before anastomosis, fluorescein angiography showed slow filling of the MCA branches through collateral channels. Focal areas of impaired microcirculatory filling and washout were seen in the territory of severely sclerotic cortical arteries. The findings of preanastomotic /sup 133/Xe clearance studies were variable and a uniform pattern of regional cerebral blood flow (rCBF) changes was not defined. In 55% of the patients, rCBF was reduced to 25 ml/100 gm/min or less at one or more detector sites. Fluorescein angiography provided an immediate assessment of anastomotic patency and clearly displayed the distribution of blood entering the epicerebral circulation through the STA. In 67% of patients, multiple MCA cortical branches filled with fluorescein, whereas in 33% filling was restricted to the receptor artery territory. An immediate, substantial (greater than or equal to 15 ml/100 gm/min) increase in rCBF was demonstrated in 73% of patients after anastomosis. The rCBF changes were consistently better in patients with donor and receptor arteries greater than 1 mm in diameter. Redistribution of collateral input acted to increase rCBF in areas distant from the anastomotic site. Some improvement in fluorescein circulation and rCBF also was seen in cortex supplied by sclerotic MCA branches.

• Research Organization: Montreal Neurological Inst., Quebec
• OSTI ID: 6689729
• Journal Information: J. Neurosurg.; (United States), Journal Name: J. Neurosurg.; (United States) Vol. 50:5; ISSN JONSA
• Country of Publication: United States
• Language: English

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
AROMATICS
ARTERIES
ARTERIOSCLEROSIS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOMEDICAL RADIOGRAPHY
BLOOD FLOW
BLOOD VESSELS
BODY
BRAIN
CARBOXYLIC ACIDS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CAROTID ARTERIES
CENTRAL NERVOUS SYSTEM
CEREBRUM
CLEARANCE
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
DYES
EVEN-ODD NUCLEI
FLUORESCEIN
HYDROXY ACIDS
HYDROXY COMPOUNDS
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
NERVOUS SYSTEM
NUCLEAR MEDICINE
NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANS
PATIENTS
PHENOLS
POLYPHENOLS
RADIOISOTOPES
RADIOLOGY
SURGERY
VASCULAR DISEASES
XENON 133
XENON ISOTOPES