Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2024; 12(31): 6479-6485
Published online Nov 6, 2024. doi: 10.12998/wjcc.v12.i31.6479
Recipient artery dissection during extracranial-intracranial bypass surgery: Two case reports
Yong-Jun Lee, Wan Park, Sung-Pil Joo
Yong-Jun Lee, Sung-Pil Joo, Department of Neurosurgery, Chonnam National University Hospital and Medical School, Gwangju 61469, South Korea
Wan Park, Department of Neurosurgery, Chonnam National University Hospital, Gwangju 61469, South Korea
Author contributions: Lee YJ contributed to manuscript writing and editing, and data collection; Park W contributed to data collection; Joo SP contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Supported by Chonnam National University Hospital Biomedical Research Institute, No. BCRI24031.
Informed consent statement: Informed written consents were obtained from the patients for publication of these two reports and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sung-Pil Joo, MD, Doctor, Department of Neurosurgery, Chonnam National University Hospital and Medical School, 42, Jebong-ro, Dong-gu, GwangJu 61469, South Korea. nsjsp@jnu.ac.kr
Received: April 21, 2024
Revised: August 13, 2024
Accepted: August 19, 2024
Published online: November 6, 2024
Processing time: 142 Days and 23.4 Hours
Abstract
BACKGROUND

Superficial temporal artery to middle cerebral artery (STA-MCA) bypass is a valuable treatment for preventing ischemia and hemorrhage in occlusive cerebrovascular disease. Anastomosis site dissection is rarely reported among the various bypass-related complications.

CASE SUMMARY

In this case report, we describe two patients, who were 63- and 59-years-old with middle cerebral artery occlusion treated by STA-MCA bypass. During bypass surgery, the recipient M4 artery intima was dissected. We sacrificed the dissecting portion, and no complications occurred during the follow-up period. Postoperative brain imaging revealed improved brain perfusion. We report rare cases of recipient artery dissection located in the extracranial to intracranial bypass site, and we suggest atherosclerotic changes in the recipient artery and insufficient puncture as the causes.

CONCLUSION

Appropriate recipient artery selection is critical, and if dissection occurs, it is essential to sacrifice the dissecting portion quickly.

Keywords: Anastomosis site dissection; Pseudoaneurysm; Bypass; Atherosclerosis; Recipient artery; Case report

Core Tip: The pathological cause of anastomosis site dissection is not precisely understood. We present two rare cases of recipient artery dissection during superficial temporal artery-middle cerebral artery bypass. In order to take appropriate action when these cases occur, more case studies are needed on the causes. We proposed the atherosclerotic change of the recipient artery as the cause.