CEREBRAL REVASCULARIZATION BY OMENTAL FREE-FLAP USING CONTRALATERAL SUPERFICIAL TEMPORAL VESSELS AS RECIPIENT VESSELS - CASE-REPORT

BACKGROUND Although the most common technique of cerebral revasculariz ation is superficial temporal artery to middle cerebral artery bypass, we occasionally encounter a situation in which the ipsilateral superf icial temporal artery is not available. Treatment may require several techniques including long vein graft bypass. METHODS A 54-year-old man experienced transient ischemic attacks, and cerebral angiography reve aled occlusion of the right common carotid artery. Cerebral blood flow study revealed reduced perfusion reserve capacity of the right cerebr al hemisphere. We applied an omental free flap to the brain surface us ing the contralateral superficial temporal vessels as recipient vessel s, RESULTS Cerebral blood flow study revealed improvement of perfusion reserve capacity. Cerebral angiography revealed good collateral circu lation from the omentum to the brain. The patient has not experienced a transient ischemic attack, following additional ligation of the occi pital artery 13 months after the first operation. CONCLUSIONS Because an omental flap has a long pedicle and its circulation can be monitore d easily, this method is safe and as effective as a long bypass graft in a patient such as ours in whom the ipsilateral superficial temporal artery is not available for anastomoses. (C) 1997 by Elsevier Science Inc.