Superficial temporal artery dissection: a technical note.

BACKGROUND Dissection of the superficial temporal artery (STA) is often required in preparation for a bypass procedure. Traditionally, dissection of the STA involves a direct cutdown on the artery after marking the course of the artery on the skin with the help of a Doppler ultrasound probe. OBJECTIVE We describe a method that takes advantage of the position of the STA superficial to the temporal fascia. METHODS The technique was used in a total of 38 procedures in 32 patients to create synangiosis or extracranial-intracranial STA bypasses. The STA was dissected using a blunt malleable brain retractor that was inserted into the subgaleal plane directly over the STA, allowing creation of a linear incision and concurrent protection of the STA in its bed. Either computed tomography- or catheter-based angiography was used to evaluate the patency postoperatively. RESULTS All STA vessels were dissected without complications or injury to the graft vessel. The sole complication was a superficial wound breakdown in a synangiosis case. Postoperative angiography demonstrated patency in all but 1 of the 24 bypass cases (95.8%). CONCLUSION We describe a method that takes advantage of the position of the STA superficial to the temporal fascia to allow rapid, safe, and efficacious dissection. The incision is linear and easier to manage and close. In our series, there were no technical complications related to the dissection of the STA.