BACKGROUND: Various bypass procedures have been used to treat occlusive cerebrovascular diseases. Most procedures were performed to prevent further ischemia in the territory of the middle cerebral artery, while only a few of the papers discuss the anterior cerebral artery (ACA) territory. METHOD AND RESULTS: A patient who initially presented with several episodes of transient monoparesis in the left leg was found to have severe stenosis of the right A2-A3 junction. A free superficial temporal artery (STA) graft was anastomosed between the right A2 and A3 portion intracranially. Transient ischemic attacks immediately disappeared after surgery and subsequent cerebral angiography revealed good anterograde filling from the A2 to A3 portion via the free STA graft. CONCLUSION: Revascularization using a free STA graft is useful for reconstruction of a local stenotic lesion, especially in the ACA territory.
BACKGROUND: Various bypass procedures have been used to treat occlusive cerebrovascular diseases. Most procedures were performed to prevent further ischemia in the territory of the middle cerebral artery, while only a few of the papers discuss the anterior cerebral artery (ACA) territory. METHOD AND RESULTS: A patient who initially presented with several episodes of transient monoparesis in the left leg was found to have severe stenosis of the right A2-A3 junction. A free superficial temporal artery (STA) graft was anastomosed between the right A2 and A3 portion intracranially. Transient ischemic attacks immediately disappeared after surgery and subsequent cerebral angiography revealed good anterograde filling from the A2 to A3 portion via the free STA graft. CONCLUSION: Revascularization using a free STA graft is useful for reconstruction of a local stenotic lesion, especially in the ACA territory.