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At least 55 records · Page 3Linked to original sources
PubMed2004

Superficial temporal artery to middle cerebral artery bypass.

The superficial temporal artery to middle cerebral artery bypass is an elegant procedure that was developed and first performed by M. Gazi Yaşargil. It has been used by neurosurgeons for more than 30 years in the management of neurovascular disorders such as cerebrovascular ischemic disease, moyamoya disease, and complex intracranial aneurysms. Mastering the technique requires not only precise and fine skills but also devoted training in the microsurgery laboratory. The technique presented in this article evolved from the long and vast experience of the senior author (DWN) in performing superficial temporal artery to middle cerebral artery bypasses for a variety of cerebrovascular conditions.

Anastomosis, Surgical↗
PubMed2000

Cytokine enhancement of endothelin ET(B) receptor-mediated contraction in human temporal artery.

Segments of human temporal artery were incubated in organ culture for 2 days in the absence or presence of cytokines. Thereafter, contractions were induced by the selective endothelin ET(B) receptor agonist sarafotoxin S6c, a peptide that does not induce contraction in fresh human temporal artery. Interleukin-1beta was most potent in increasing the sarafotoxin-induced contraction in cultured segments. Tumour necrosis factor (TNF)-alpha increased the magnitude of contraction to a similar degree, but at a higher dose. A significant increase was also induced by interferon-gamma, but not by interleukin-6 at the concentrations used. The results suggest that endothelin ET(B) receptor-mediated contraction can be enhanced by pro-inflammatory cytokines in a concentration-dependent manner, and this may have relevance for pathophysiological conditions where inflammation and vasoactivity are important.

Cytokines↗
PubMed1999

Distribution of the superficial temporal artery in the Chinese adult.

The superficial temporal artery is important in head and neck surgery. Ethnologic variation may affect surgical procedure. In this study, we evaluated the variations of the artery in Chinese adults. We measured its bifurcating location, the diameter of its vessels, and its relationship to nearby structures. A total of 26 cadavers with 52 superficial temporal arteries were examined in 3 consecutive years. The superficial temporal artery ran 1.14 cm anteriorly to the bony external auditory canal. The average diameters of the superficial temporal artery, frontal branch, and parietal branch were 2.14, 1.61, and 1.68 mm, respectively. In 45 of 52 cases (86.5 percent), bifurcation of the artery occurred well above the zygomatic arch. The present study thus demonstrated that the superficial temporal artery in the Chinese adult differs from that in the Caucasian and has provided a detailed anatomic distribution analysis of the superficial temporal artery in Chinese adults, which should benefit the clinician in dealing with operation procedures related to this artery.

Adult↗
PubMed1989

[The course of the superficial temporal artery. Anatomic studies as a prerequisite to arterial biopsy].

The superficial temporal artery, together with its branches, was dissected in 161 half-heads, and the course of these vessels mapped against a newly-developed grid which can be adapted to conform to the proportions of each individual skull. The practical aim of this investigation was to establish the position of that incision which has the highest probability of being well-placed for taking a biopsy from the frontal branch of the artery. In 86.3% of the authors' specimens it was possible to reach this vessel through a 2.5 cm incision running up-ward and posteriorward at an angle of 45 degrees to the "upper horizontal line" from a point 1-1.5 cm behind the intersection of this line with the "lateral border of the orbit". The commonest type of ramification, with two terminal branches, was found in 94.6% of the specimens. Type 2 (with three terminal branches) occurred in 2.5% and Type 3 (with a single terminal branch) also in 2.5% of the cases. The level of the bifurcation of the superficial temporal artery varied between a point 2 cm below the "German horizontal line" and a second point 2 cm above the "upper horizontal line". The main trunk of the vessel was found to make an angle of 82.2 degrees with the "German horizontal line", its frontal branch running upward and anteriorward at an angle of 40 degrees to this line.

Biopsy↗
PubMedDate not supplied

Superselective continuous arterial infusion chemotherapy through the superficial temporal artery for oral cavity tumors.

BACKGROUND AND PURPOSE: High-dose intraarterial chemotherapy with repeated one-shot infusion may be useful for treating head and neck tumors. We evaluated the efficacy of superselective continuous arterial infusion chemotherapy administered via a coaxial catheter system and compared the results with those of subselective catheterization for treatment of oral cavity tumors. METHODS: Forty-nine consecutive patients with tumors of the oral cavity (clinical stage I, 12 cases; stage II, 19 cases; stage III, six cases; stage IV, 12 cases) were treated by arterial infusion chemotherapy. After a guiding catheter was advanced into the superficial temporal artery, superselective catheterization was performed using a coaxial system microcatheter. Superselective catheterization was accomplished in 34 cases, and was unsuccessful in 15, owing to difficulties in performing catheterization or to multiple feeding arteries. In the latter cases, the tip of the catheter was placed near the origin of the feeding arteries (subselective catheterization). RESULTS: Thirty (88%) of 34 patients had a complete response to superselective arterial infusion chemotherapy and two (6%) had a partial response. Twelve (80%) of 15 patients had a complete response to subselective arterial infusion chemotherapy and three (20%) had a partial response. Local recurrence was more frequent after subselective treatment (13%) than after superselective (6%) treatment. CONCLUSION: Superselective continuous arterial infusion chemotherapy may be suitable for local control of oral cavity tumors, with a low rate of recurrence.

Adult↗
PubMed1991

Histamine receptors in the isolated human middle meningeal artery. A comparison with cerebral and temporal arteries.

The subtypes of histamine receptors mediating dilatation of human meningeal arteries have been tested in vitro, using "selective" antagonists, and compared with cerebral and temporal arteries previously examined. Dilatory responses were tested after preconstriction with prostaglandin F2 alpha. Both mepyramine and cimetidine caused a parallel shift to the right of the histamine concentration-response curve, suggesting the presence of both H1- and H2-receptors. Combined treatment with mepyramine and cimetidine caused further displacement of the concentration-response curve to the right. Schild analysis indicated pA2 values of 6.3 for cimetidine and 9.8 for mepyramine in situations of near complete blockade of either of the receptors. Both H1- and H2-receptors seem of importance for the histamine-induced dilatation in meningeal arteries and neither appear to dominate. The data considered in conjunction with our previous findings support the finding that experimental histamine-induced headache due to vasodilatation is intracranial of origin.

Adult↗
PubMed2002

Venous drainage architecture of the temporal and parietal regions: anatomy of the superficial temporal artery and vein.

Anatomy of the superficial temporal artery and vein was analyzed with arteriograms, venograms, and arteriovenograms of fresh cadavers that had been injected with contrast medium. The superficial temporal artery always divided into two major branches: the frontal and parietal branches. However, the superficial temporal vein divided into one, two, or three major branches. The distribution area of the major branches of the superficial temporal vein was larger than that of major branches of the superficial temporal artery, and arteriovenograms clearly demonstrated that, except for its proximal portion, the superficial temporal vein was independent of the superficial temporal artery. The frontal and parietal branches of the superficial temporal artery had thin venae comitantes that originated from the proximal portion of the superficial temporal vein, and the venae comitantes gave off branches toward the skin and the underlying soft tissue. Branches to the skin anastomosed with a superficial venous network in the skin layer, which was formed by ramifications of the superficial temporal vein. The venous architecture of the temporal and parietal regions consisted of cutaneous veins and venae comitantes and was basically similar to that of the forearm and scapular region.

Humans↗
PubMed1995

The influence of sectional interval on the reliability of temporal arterial biopsies in polymyalgia rheumatica.

Temporal arterial biopsies from 27 patients with a clinical diagnosis of pure polymyalgia rheumatica (PMR) were examined using light microscopy on paraffin and plastic sections. The primary routine examination of the paraffin-embedded parts of the biopsies (biopsy length: 12.7 +/- 4.5 mm, sub-segments: 4.9 +/- 1.2 mm) revealed 4 positive cases, whereas the primary examination of the smaller plastic-embedded parts showed inflammation in 6 cases (biopsy length: 2.7 +/- 1.2 mm, sub-segments: 0.7 +/- 0.3 mm). Serial sectioning with a 50 microns interval of arteries which were negative primarily revealed three new positive cases in the paraffin-embedded material (total length: 174.0 mm), whereas sectioning the plastic-embedded material (total length: 52.8 mm) produced one more positive artery. All the new cases displayed a focal inflammatory process in atrophic, calcified arterial segments. The high yield of positive biopsies in the present material (11 of 27; 40.7%) demonstrates the diagnostic value of temporal arterial biopsy in PMR and the importance of a careful histologic examination. The results also indicate the influence of biopsy length on the yield of positive biopsies. The division of fixed temporal arterial biopsies into approximately 1-mm-long sub-segments before the embedding and the further serial sectioning of those negative biopsies which are atrophic and/or calcified is recommended in cases of pure PMR.

Aged↗
PubMed1978

[Long-term measurement of arterial blood pressure via the superficial temporal artery (author's transl)].

The method used for prolonged continuous measurement of arterial blood pressure in surgical intensive care unit is describe. It was employed in 150 persons aged 1--65 year for periods of up to 30 days. It involved arteriotomy of the super-ficial temporal artery followed by the insertion of a catheter. The absence of side-effects in any of the 150 patients makes this technique very suitable for prolonged continuous blood pressure measurements.

Adolescent↗
PubMed2001

Facial nerve injury following superficial temporal artery biopsy.

BACKGROUND: With proper training, superficial temporal artery biopsy is a safe office procedure with few complications. Surgeons from different disciplines, including ophthalmologists, dermatologists, general surgeons, and plastic surgeons may be called upon to perform this common procedure to confirm giant cell arteritis. OBJECTIVE: To emphasize the surgical anatomy of the scalp as it pertains to superficial temporal artery biopsy and to raise awareness that significant complications can occur after superficial temporal artery biopsy. METHOD: Case report. RESULTS: A 75-year-old woman with presumed giant cell arteritis developed frontalis muscle paralysis following a superficial temporal artery biopsy. Biopsy selection site within the danger zone combined with deep dissection carries the greatest risk of injury to the temporal branches of the facial nerve. CONCLUSION: Any surgeon involved in the practice of performing superficial temporal artery biopsies should have a thorough understanding of proper surgical techniques and regional anatomy to avoid potential devastating complications.

Aged↗
PubMed2005

Superficial temporal artery to middle cerebral artery bypass.

The superficial temporal artery to middle artery bypass is a technique that allows the blood supply from the extracranial carotid circulation to be routed to the distal middle cerebral artery branches. The procedure allows blood flow to bypass proximal lesions of the intracranial vasculature. The performance of this bypass requires specialized microvascular training and the use of microvascular techniques. The techniques involved in performing these procedures include microdissection of the superficial temporal artery in the scalp, microdissection of the recipient middle cerebral artery branches near the sylvian fissure, and anastomosis techniques using either microvascular sutures or a microanastomotic device. The successful completion of the bypass and subsequent patency requires meticulous attention to technical details.

Journal Article↗
PubMed2005

Does temporal artery biopsy influence the management of temporal arteritis?

BACKGROUND: Temporal arteritis (TA) is the commonest form of primary vasculitis. Symptoms are variable, and therefore the diagnosis (or exclusion) of TA is often difficult. Surgeons are frequently asked to perform a temporal artery biopsy (TAB), but whether the histological result actually influences clinical management is unclear. AIM: To assess whether, in routine clinical practice, a TAB affects clinical decision-making in patients with suspected TA. DESIGN: Retrospective audit. METHODS: All patients who underwent a TAB in a single hospital over a 2-year period were identified. This included patients referred from different specialist departments. Individual patient records were examined to document the TAB result, and in particular, the timings of commencement and discontinuation of corticosteroid therapy. RESULTS: A total of 44 patients were included. TAB was positive in seven patients and negative in 37. In 31, there was no change in their clinical management despite a negative biopsy result: 18 continued with corticosteroids for >6 months with a clinical diagnosis of TA, and in 13 patients a decision to stop steroids, or an alternative diagnosis, was made before the biopsy result was known. DISCUSSION: In this retrospective study, only a small number of TABs provided positive histological confirmation of TA, and in most patients undergoing TAB, there was little evidence that clinical decision-making with respect to corticosteroid therapy was influenced by the TAB result.

Adrenal Cortex Hormones↗
PubMed1995

[Spontaneous dissecting aneurysm of the superficial temporal artery: a case report].

Aneurysms of the superficial temporal artery are rare, and usually traumatic in origin. We present a very rare case of spontaneous dissecting aneurysm of the superficial temporal artery in a 46-year-old man. The patient had pulsatile headache in the right temporal region, and a pulsatile mass in the same region. His headache gradually worsened for which he came to our hospital. On examination, there was a pulsatile mass of 1.5cm x 3cm at the right temporal region, which disappeared when the main trunk of superficial temporal artery was compressed. There was no neurological abnormality. On computed tomographic examination, there was a spotty high density area in the right extracranial region corresponding to the right superficial temporal artery, which was strongly enhanced after contrast medium administration. On MRI examination, the same area showed high intensity, but at inner space there was signal loss on T1WI, T2WI and PDWI. Angiography showed an aneurysmal dilatation at the right superficial temporal artery and both the true lumen and the false lumen were recognized. Excision of the aneurysm under local anesthesia was performed. His complaints disappeared completely post-operatively, and the skin color of that region retained its normal texture. Histopathological examination of the specimen showed hypertrophic intima with fibroblasts, and absence of internal elastic lamina. There was hematoma outside of the intima, but no deposits of hemosiderin. On account of the above findings, the lesion was diagnosed as a spontaneous dissecting aneurysm of the superficial temporal artery.

Aortic Dissection↗
PubMed2002

Arterial wall production of cytokines in giant cell arteritis: results of a pilot study using human temporal artery cultures.

BACKGROUND: Giant cell arteritis (GCA) is a subacute periarteritis predominantly affecting segments of the external carotids of elderly patients. Vasculitic lesions in GCA samples might be characterized by in situ production of cytokines mRNA, indicative of macrophage and T-cell activation. However, whether the cytokine production of vessels with arteritis differs from that of vessels exposed to inflammatory conditions that originate peripheral to the vessel remains unknown. METHODS: We investigated cytokine and soluble receptor cytokine production in blood samples and cultures of human temporal arteries from 22 consecutive patients (mean age 77 +/- 6 years) further investigated for possible diagnosis of GCA: 7 patients had GCA and 15 had neither GCA nor vasculitis but had other inflammatory, infectious, or malignant diseases (controls). The production of cytokines and soluble cytokine receptors in the supernatants of cultures of 3-mm segments of temporal artery specimens, before and after lipopolysaccharide (LPS) stimulation (10 ng/ml and 10 microg/ml) and in serum, was quantified using sandwich enzyme-linked immunosorbent assay (ELISA). RESULTS: Cytokine production by temporal arteries increased significantly and in a dose-dependent manner (p <.01) after LPS stimulation in all patients studied, suggesting that the system is methodologically functional. Despite a large interindividual variation, we found similar differences in cytokine production before and after stimulation by 10 ng/ml and 10 microg/ml LPS between both groups: temporal arteries of GCA patients produced more interleukin (IL)-1beta (p <.05) and IFNgamma (nonsignificant) and less tumor necrosis factor (TNF)alpha (p <.05) and IL-6 (nonsignificant) than temporal arteries of controls. The levels of TNFalpha (p <.05) and IL-6 soluble receptor (p <.05) were significantly lower in GCA patients as compared with controls in blood samples, whereas levels of cytokines in temporal artery and in blood samples were not significantly correlated at the individual level in both groups. CONCLUSIONS: The present pilot study, which requires further confirmation on a larger number of well-defined patients with GCA, suggests that a specific arterial cytokine production profile might exist in GCA (high IL-1beta +/- IFNgamma and low TNFalpha), addresses the question of the mechanisms by which IL-1beta and TNFalpha might be differentially regulated at the level of the arterial cell wall, and supports the view that cultures of the temporal artery might be an interesting tool for evaluating the role of cytokines in GCA pathogenesis.

Aged↗
PubMed2003

Proximal superficial temporal artery to proximal middle cerebral artery bypass using a radial artery graft: an anatomic approach.

We present the use of radial artery graft for bypass of the proximal superficial temporal artery to the proximal middle cerebral artery. Six adult cadaver sites were used bilaterally. After apterional incision, 2x2-cm minicraniectomy was performed which began 2 cm behind the zygomatic process of the frontal bone. The superficial temporal artery was transsected before exposing the zygomatico-orbital artery branch. The proximal side of the radial artery graft was anastomosed end-to-end to the proximal superficial temporal artery and the distal side end-to-side to the proximal middle cerebral artery. The mean calibers of the proximal superficial temporal artery and largest trunk of the middle cerebral artery were 2.25+/-0.35 mm and 2.3+/-0.3 mm, respectively. The average graft length was 85+/-5.5 mm. We conclude that such bypasses are simpler than proximal middle cerebral artery revascularization using long vein grafts. This method proves that the caliber of the proximal superficial temporal artery is more suited to providing sufficient flow than the distal superficial temporal artery, and the graft is short. Such bypasses to the middle cerebral artery may be an alternative to those from the distal superficial temporal artery or extracranial carotid artery.

Adult↗