Bypass Of The Maxillary To Proximal Middle Cerebral Artery:An Anatomical And Technical Study

Objective:To examine the feasibility of bypass between the maxillary artery (MA) and proximity of middle cerebral artery (MCA).Methods:10fixed and perfused adult cadaver heads were carried out bilaterally, a total of20sides. After a frontotemperal craniotomy, the superficial temporal artery and its two branches were dissected, and their outer diameters were measured respectively. Under the zygomatic arch,the MA and its branch, deep temporal artery, were located and MA’s outer diameter was measured in the infratemporal fossa. After the sylvian fissure was opened, the MCA bifurcate department was separated under the microscope. after the common carotid artery, external carotid artery and internal carotid artery had been exposed and the lengths between the external carotid artery, internal carotid artery, maxillary artery and proximal middle cerebral artery were measured respectively.10healthy adults as targets (20sides), inner diameter and blood flow dynamic parameters of the common carotid artery, external carotid artery, internal carotid artery, maxillary artery superficial temporal artery and its two branches were measured with ultrasound examination. All of records were processed with SASS software.Results:The outer diameter of MA (2.6±0.2mm) was larger than the outer diameter of the temporal artery trunk (1.7±0.3mm). The lengths of grafts vessels between the internal carotid artery,external carotid artery and MCA bifurcate department (171.0±2.7mm and162.4±2.6mm), were longer than The lengths of grafts vessels between MA and MCA bifurcate department (61.7±1.5mm). Blood flow of the second part of MA (62.7±13.3ml/min) was more than the blood flow of the two branches of the superficial temporal artery (15.9±3.7ml/min,17.7±4.1ml/min).Conclusion:Bypass between the maxillary artery (MA) and proximity of middle cerebral artery (MCA) is feasible; With this kind of bypass, the graft vessel is shorter and more straight than the bypass between internal carotid artery,external carotid artery and proximity of middle cerebral artery (MCA).It is a kind of effective high flow bypass.When dealing with diseases need high flow bypass, the MA-to-proximal MCA bypass may be an alternative to the superficial temporal artery-to-MCA bypass, as well as to internal or external carotid artery-to-MCA bypass.