Abstract
Objectives: Patients complaining with vertigo or dizziness, the pathology may be originated from central or peripheric compartment. These cases frequently apply to the Neurology, Neurosurgery, or ENT Clinics. The vertebro-basilar insufficiency is one of the most common pathologic causes of central vertigo or dizziness. This study aims to examine the use of a radial artery graft for bypass of the maxillary artery (MA) to proximal posterior cerebral artery (PCA) as an alternative to external carotid artery (ECA) to PCA anastomosis used for posterior circulation bypass surgery.
Methods: This method was applied to 5 adult cadaver sides bilaterally. The MA was easily found 1−2 cm beneath to infratemporal crest, after a frontotemporal craniotomy and a zygomatic arch osteotomy. Extradurally 2−3 cm posterolateral to the foramen rotundum, a hole was drilled in the sphenoid bone with a 4−mm tipped drill. After sylvian fissure, interpedincular and ambient cisterns were opened, the P2 segment of the PCA appeared. The graft was passed through the hole and the dura to reach the P2 segment. Before giving the infraorbital artery (IOA) branch, the MA was freed from the surrounding tissue and transsected. The proximal side of the radial artery graft was anastomosed end-to-end with MA and distal side end-to-side with P2 segment of PCA.
Results: The average diameter of the MA before giving the IOA branch was 2.6 $pT 0.3 mm. The average diameter of the P2 was 2.2 $pT 0.2 mm. The average length of the graft was 47 $pT 5.2 mm.
Conclusion: Since MA to proximal PCA bypass uses a short radial graft and may provide a sufficient blood flow, it can pose a reasonable alternative to ECA to PCA bypass.
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