2025 Poster Presentations
P440: STENT ASSISTED STA-MCA BYPASS SUTURING TECHNIQUE- CASE REPORT
Freddie Rodriguez Beato, MD1; Huy Duong, MD2; 1University of California, Davis; 2Kaiser Permanente, Sacramento
Superficial temporal artery-middle cerebral artery(STA-MCA) bypass is a well documented procedure used to treat Moya Moya disease.
Here we present a case of 49 year old female with Moya Moya disease who presented
a few months prior to our evaluation with right hemiparesis and slurred speech.
Brain MRI/MRA showed DWI restriction in left MCA territory and severe stenosis in left M1.
She was referred to neurosurgery for evaluation for bypass surgery. A left frontotemporal craniotomy was performed. A double barrel bypass was performed with the frontal branch of STA to cortical M4 branches. There was no viable donor STA parietal branch. After multiple attempts at anastomosis, the tip of a 22 gauge plastic needle was inserted inside the lumen. This gave the artery its natural form and proved to be a more efficient and faster way of anastomosing the arteries. Indocyanine green angiography and post op computed tomography angiogram showed patent bypass.
There were no complications and the patient had no neurologic deficits post op.