TY - JOUR
T1 - The value of the middle meningeal artery in cerebrovascular bypass surgery
T2 - An anatomic feasibility study
AU - Niknejad, Hamid Reza
AU - van der Zwan, Albert
AU - Heye, Sam
AU - Van Calenbergh, Frank
AU - Van Loon, Johannes
PY - 2018/7/1
Y1 - 2018/7/1
N2 - BACKGROUND: Over the past decade, there has been a revival and a renewed interest for cerebrovascular bypass procedures. The superficial temporal artery (STA) has its value as a reliable donor vessel; however, a possible role for themiddlemeningeal artery (MMA) as a donor artery is still unclear. OBJECTIVE: To assess the feasibility of using theMMA as a donor vessel in cerebrovascular surgery. METHODS: We performed cadaveric dissections on 12 fresh specimens (23 sides) after bilateral silicone injection into the internal and external carotid arteries.We compared the size, diameter, and possibility to perform a bypass to the middle cerebral artery for both the MMA and the STA. Measurements were done using an electrical caliper. Additional measurements of the MMA and STA were performed on 20 random angiograms. RESULTS: There was no statistically significant difference in diameter of the MMA at its ostium being 2.4 mm, compared to 2.7 mm for the STA ostium (t-test; P = .21). The MMA could be mobilized over 4.1 cm, whereas the STA over 8.3 cm. Finally, the mean diameter of the donor vessel at the site of the anastomosis was 1.6 mm versus 1.9 mm for MMA and STA, respectively (P = .0026).We were able to perform anMMA and middle cerebral artery anastomosis on 17 sides. CONCLUSION: These results suggest that the MMA is a potentially valuable donor vessel to be used in selected cases. The availability of a suitable MMA branch should be assessed preoperatively on the angiogram.
AB - BACKGROUND: Over the past decade, there has been a revival and a renewed interest for cerebrovascular bypass procedures. The superficial temporal artery (STA) has its value as a reliable donor vessel; however, a possible role for themiddlemeningeal artery (MMA) as a donor artery is still unclear. OBJECTIVE: To assess the feasibility of using theMMA as a donor vessel in cerebrovascular surgery. METHODS: We performed cadaveric dissections on 12 fresh specimens (23 sides) after bilateral silicone injection into the internal and external carotid arteries.We compared the size, diameter, and possibility to perform a bypass to the middle cerebral artery for both the MMA and the STA. Measurements were done using an electrical caliper. Additional measurements of the MMA and STA were performed on 20 random angiograms. RESULTS: There was no statistically significant difference in diameter of the MMA at its ostium being 2.4 mm, compared to 2.7 mm for the STA ostium (t-test; P = .21). The MMA could be mobilized over 4.1 cm, whereas the STA over 8.3 cm. Finally, the mean diameter of the donor vessel at the site of the anastomosis was 1.6 mm versus 1.9 mm for MMA and STA, respectively (P = .0026).We were able to perform anMMA and middle cerebral artery anastomosis on 17 sides. CONCLUSION: These results suggest that the MMA is a potentially valuable donor vessel to be used in selected cases. The availability of a suitable MMA branch should be assessed preoperatively on the angiogram.
KW - Anastomosis
KW - Bypass
KW - Caliber
KW - Middle meningeal artery
UR - http://www.scopus.com/inward/record.url?scp=85050544922&partnerID=8YFLogxK
U2 - 10.1093/ons/opx200
DO - 10.1093/ons/opx200
M3 - Article
AN - SCOPUS:85050544922
SN - 2332-4252
VL - 15
SP - 89
EP - 96
JO - Operative Neurosurgery
JF - Operative Neurosurgery
IS - 1
ER -