Is STA really a low‐flow graft? A quantitative ultrasonographic study of the flow of STA for cerebral revascularization in MMD patients

Objective Direct revascularization remains an important tool in the treatment of patients with Moyamoya disease (MMD). The superficial temporal artery (STA) is the most commonly used donor vessel for direct bypass, and an STA graft has traditionally been considered a low‐flow graft for flow augmenta...

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Published in:CNS neuroscience & therapeutics 2023-09, Vol.29 (9), p.2572-2582
Main Authors: Wen, Yunyu, Gou, Yanxia, Wang, Baoping, Wang, Zhibin, Chen, Siyuan, Zhang, Shichao, Zhang, Guozhong, Li, Mingzhou, Feng, Wenfeng, Qi, Songtao, Wang, Gang
Format: Article
Language:English
Subjects:
Anastomosis
Blood flow
Blood vessels
cerebrovascular disease
Flow velocity
Heart surgery
Independent variables
Ischemia
Medical imaging
Moyamoya disease
Original
Patients
quantitative ultrasonography
Statistical analysis
STA‐MCA bypass
stroke
Ultrasonic imaging
Variance analysis
Veins & arteries
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Summary:Objective Direct revascularization remains an important tool in the treatment of patients with Moyamoya disease (MMD). The superficial temporal artery (STA) is the most commonly used donor vessel for direct bypass, and an STA graft has traditionally been considered a low‐flow graft for flow augmentation. This study aimed to quantitatively evaluate the blood flow of the STA after direct revascularization. Methods All direct revascularization procedures performed between 2018 and 2021 by one experienced neurosurgeon were screened. Quantitative ultrasound was used to measure the flow data of the patient's bilateral parietal branch of the STA(STA‐PB), the bilateral frontal branch of the STA(STA‐FB), and the left radial artery. Data on the patients' basic information, Suzuki grade, Matsushima type, anastomosis type, and blood biochemical parameters were collected and analyzed using univariate and multivariate models. An MBC Scale scoring system was proposed to evaluate the recipient artery network of the middle cerebral artery (MCA) tree. The relationship between MBC Scale score and STA graft flow was statistically analyzed. Results In total, 81 patients (43 males and 38 females) successfully underwent STA‐MCA bypass and were included in this study. The mean flow rates in the STA‐PB graft on 1 day preoperatively, 1 day postoperatively, 7 days postoperatively, and >6 months postoperatively (long‐term) were 10.81, 116.74, 118.44, and 56.20 mL/min respectively. Intraoperative graft patency was confirmed in all patients. Comparing the preoperative and all postoperative time points, the STA‐PB flow rates were statistically significant (p 
ISSN:1755-5930
1755-5949
DOI:10.1111/cns.14197