Case Report
Copyright ©The Author(s) 2023.
World J Clin Cases. Mar 26, 2023; 11(9): 2091-2097
Published online Mar 26, 2023. doi: 10.12998/wjcc.v11.i9.2091
Figure 1
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Figure 1 Case 1 perioperative imaging. A: Initial magnetic resonance imaging indicated a small left frontal infarction from the left middle cerebral artery (MCA) stenosis (yellow arrow); B: On the transfemoral cerebral angiography (TFCA), the left superficial temporal artery was thin with weak flow (yellow arrow); however, the occipital artery (OA) was prominent (black arrows); C-F: After the OA-MCA bypass, blood flow at the surgical site was intact on postoperative TFCA (D and E; yellow arrow), with a perfusion defect improvement on postoperative Diamox SPECT compared with the preoperative scan (C and F; yellow arrows).
Figure 2
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Figure 2 Case 2 perioperative imaging. A: Initial transfemoral cerebral angiography (TFCA) indicated right middle cerebral artery (MCA) occlusion (yellow arrow); b: The right superficial temporal artery was thin with weak flow (yellow arrow); however, the occipital artery (OA) was prominent (black arrows); C-F: After the OA-MCA bypass, blood flow at the surgical site was intact on postoperative TFCA (D and E; yellow arrows), with a perfusion defect improvement on postoperative perfusion magnetic resonance imaging compared with the preoperative scan (C and F; yellow arrows).
Figure 3
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Figure 3 Occipital artery-middle cerebral artery bypass surgical position and incision. A: In the three-quarter position, the retrosigmoid area was at the top, and the vertex was slightly raised. The occipital artery (OA) course was confirmed through angiography with fingertip palpating. An incision was created consecutively at the craniotomy site for the recipient artery; B: The OA’s main artery had a very tortuous course (black arrows); therefore, the soft tissue was dissected along the bend to secure the stretched curve’s full length to the recipient site, at least 7 cm; C and D: To prevent donor artery compression in the supine position, a route between the craniotomy site and OA’s proximal part was cut to create a sough (black arrows).