It is considered controversial whether superficial temporal artery (STA)-middle cerebral artery (MCA) bypass affects the outcome of patients with
ischemic stroke. This prospective study was undertaken to demonstrate the effect of
STA-MCA bypass on the cerebral blood flow and neurological status of the patients with
ischemic stroke. Seventy-five patients underwent unilateral or bilateral
STA-MCA bypass surgery. The selection of the patients closely adhered to the criteria of the Japan EC-IC Bypass Trial (JET). Cerebral blood flow (CBF) before and after
Diamox administration was measured by single photon emission computed tomography (SPECT) using iodine-123-N-isopropyl-p-iodoamphetamine (
IMP). MRI, contrast-enhanced 3D CT scans, and angiography were performed on each patient pre- and postoperatively. Bypass surgery was successfully done in all patients. CBF was significantly increased after
STA-MCA bypass (P < 0.05). In addition, reservation of CBF was significantly improved after
STA-MCA bypass (P < 0.05). Patients with
transient ischemic attack (TIA) did not experience recurrence of such episodes after
STA-MCA bypass. The neurological deficit was unchanged in patients with complete
stroke after bypass surgery. However, the NIH
stroke scale was significantly improved after bypass surgery (P < 0.01). In addition, the satisfaction rate of treatment as assessed by the patients themselves was very high after
STA-MCA bypass (>90%) compared to the
conservative treatment group (<50%).
STA-MCA bypass still plays a limited role in the treatment of
ischemic stroke, but may become a bright hope in depressed patients after
cerebral ischemia.