STA-MCA bypass for symptomatic carotid occlusion and haemodynamic impairment

Rosalind L. Jeffree, Marcus A. Stoodley*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)


Patients with carotid artery occlusion and haemodynamic insufficiency have a high risk of stroke. Cerebral revascularization surgery improves cerebral blood flow, but it remains unclear whether this reduces the risk of stroke. This study assesses the long-term outcome of patients undergoing superficial temporal artery to middle cerebral artery (STA-MCA) bypass for symptomatic carotid occlusion. The long-term clinical follow-up and haemodynamic reserve, measured by 99Technetium single photon emission computed tomography (Tc99 SPECT) scan with acetazolamide challenge, were reviewed for 19 consecutive patients before and after STA-MCA bypass. The stroke rate after bypass surgery was 8% per year. In patients waiting for surgery, the stroke rate was 18% per year. Cerebral perfusion assessed with SPECT scan improved in 88% of patients. These results are consistent with the high risks of haemodynamic infarction in untreated patients and a benefit from revascularization surgery. The percentage annual stroke risk compares favourably with an 18% rate reported for patients with internal carotid artery occlusion and impaired cerebrovascular reserve.

Original languageEnglish
Pages (from-to)226-235
Number of pages10
JournalJournal of Clinical Neuroscience
Issue number2
Publication statusPublished - Feb 2009
Externally publishedYes


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