Salvage Techniques for STA-MCA Bypass

Superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass is a well-established, indispensable neurosurgical procedure. It is technically challenging, and surgeons must be prepared for unexpected problems. The present report describes four cases where problems arose that resulted in graft occlusion. None of these problems was directly related to the anastomosis procedure, and they occurred from early in the operation (e.g., STA preparation) to late (e.g., skin closure). In all cases, the salvage procedures used were successful, and postoperative angiography demonstrated good bypass patency.