Current status of superficial temporal artery-middle cerebral artery (STA-MCA) bypass as cerebral revascularization for occlusive lesions and complex aneurysms in the anterior circulation

Here the authors reviewed current indications and technical standards for superficial temporal artery-middle cerebral artery (STA-MCA) bypass. STA-MCA bypass is one of the most fundamental techniques for cerebrovascular surgery. Main indications are a recently symptomatic carotid or middle cerebral artery occlusive disease with misery perfusion (stage II ischemia) proven by positron emission tomography (PET) or single photon emission computed tomography (SPECT) corresponding to the inclusion criteria of the Japanese EC-IC Bypass Trial (JET) Study. STA-MCA bypass is also indicated for flow alteration or as an isolation strategy for complex aneurysm surgery. Microsurgical training in the animal lab is a key step for successful surgery especially for younger neurosurgeons.