Alternative vascular graft for extracranial–intracranial bypass surgery: descending branch of the lateral circumflex femoral artery

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>Arterial bypass is an important method of treating intracranial disease requiring sacrifice of the parent vessel. The conduits for extracranial–intracranial (EC–IC) bypass surgery include the superficial temporal artery, occipital artery, superior thyroid artery, radial artery, and saphenous vein (long or short). In an aging population with an increased prevalence of vascular disease, conduits for EC–IC bypass may be in short supply in some patients. Herein, the authors describe a case in which the descending branch of the lateral circumflex femoral artery (DLCFA) was utilized as a high-flow conduit for an EC–IC bypass.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>This 22-year-old woman presented with irregular menstrual periods, secondary amenorrhea, and hypothyroidism. A giant intrasellar and suprasellar mass was found. Angiography confirmed a 3.5 × 2.1–cm fusiform aneurysm involving the cavernous and supraclinoid segments of the right internal carotid artery. A suitable radial artery conduit was not available. The DLCFA was harvested and anastomosed between the M<jats:sub>2</jats:sub> segment of the middle cerebral artery and the external carotid artery.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Durable clinical and angiographic results were apparent at the 2-month follow-up.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The DLCFA's diameter and length were used successfully in a high-flow EC–IC bypass surgery. The DLCFA may be a good alternative to radial artery and saphenous vein grafts for an EC–IC bypass requiring high flow.</jats:p></jats:sec>

Anterolateral thigh flap pedicle for interposition artery and vein grafts in head and neck reconstruction: A case report

“…6 The descending branch of the lateral circumflex femoral artery has already been applied to vascular bypass grafting by neuro-and cardiac surgeons. 4,7 Its use for coronary bypass has been associated with high rates of patency and a low incidence of spasm. 4 Following the technique used to identify the anterolateral thigh flap pedicle, we harvested grafts with lengths from 8 to 16 cm.…”

Use of the descending branch of the lateral femoral circumflex vessels as a composite interposition graft in lower extremity reconstruction

“…[18][19][20][21] Neurosurgeons have also had success using this vessel as a conduit for extracranial to intracranial arterial bypass procedures. 22 In microsurgical procedures, Godina 23 stated that arterial interposition grafts are superior to a reverse vein graft for arterial reconstruction because there is less turbulent flow through an arterial interpostion graft than a reverse venous graft. This is likely due to the thicker walls, limited distention, and lack of valves in the artery, which equate to decreased turbulence.…”

Variation and Branching Pattern of Profanda Femoris Artery

“…The branches of the Lateral Circumflex Femoral Artery are used in anterolateral thigh flap, 5,6 aortopopliteal bypass, 7,8 coronary artery bypass grafting (CABG), 9 an extracranialintracranial (EC-IC) bypass surgery. 10 The descending branch of the artery can act as a collateral. 11 The ascending branch of the artery can be used as a supply for vascularised iliac transplantation.…”