Cerebral blood flow after superficial temporal artery-middle cerebral artery anastomosis

Objects: We made a comparative study of the cerebral blood flow (CBF) before and after single and double bypass in patients with STA-MCA anastomosis for occlusive disease of cerebral arteries. Method: This study included 35 consecutive patients who underwent STA-MCA anastomosis for occlusive disease for cerebral arteries (single bypass 19 patients, and double bypass 16 patients). CBF values and vasodilatory capacity of the ipsilateral MCA territory were evaluated by quantitative IMP-SPECT with acetazolamide (ACZ) challenge test before and 2 weeks after STA-MCA anastomosis. Regional CBF values of <32 ml/100 g/min were judged as remarkably reduced according to the definition of the Japanese EC-IC Bypass Trial. We compared the rCBF and vasodilatory capacity between single bypass (S group) and double bypass (D group) before and after the operation. Results: The rCBF values and ACZ reactivity in the ipsilateral MCA territory significantly increased 2 weeks after STA-MCA anastomosis in both groups compared with the baseline values. There was no significant difference in both groups. Conclusion: Both single and double bypass improved cerebral circulation without significant difference 2 weeks after STA-MCA anastomosis.