Saphenous Vein Graft for Bypass of the Maxillary to Supraclinoid Internal Carotid Artery: An Anatomical Short Study

The use of a saphenous vein graft for bypass of the maxillary artery (MA) to the supraclinoid internal carotid artery (ICA) in internal! carotid: occlusions is investigated. Five adult cadaver sides were used. Dissection required zygpmatic arch osteotomy and a pterional craniotomy with extensive removal of the floor of the middle cranial, fossa. The MA was found easily media[ to infratemporal crest. The clinoidal segment of the ICA was exposed with the removal of the anterior clinoid process intradurally. The bypass graft was 4 to 5 cm long and was sutured end-to-end to the MA and end-to-side to: the supraclinoid ICA. When high blood flow is needed in cases with ICA occlusion, such a bypass may be an alternative to superficial temporal (STA)-to-middle cerebral artery (MCA) bypass as well as to common carotid-to-MCA or-ICA bypass, which needs a long vein graft. This type of bypass will provide the opportunity to clip the ICA proximal to the origin of ophthalmic artery, which may inhibit distal embolization.