{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:37:07Z","timestamp":1747147027017,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Extracranial\u2013intracranial bypass has been shown to be effective in the surgical treatment of moyamoya disease, complex aneurysms, and tumors that involve proximal vasculature in carefully selected patients. Branches of the superficial temporal artery (STA) are used commonly for the bypass surgery; however, an appropriate length of the donor vessel must be harvested to avoid failure secondary to anastomotic tension. The goal of this cadaveric study was to investigate quantitatively operative techniques that can increase the STA length available to facilitate tension\u2010free STA\u2010middle cerebral artery (MCA) bypass. We conducted a cadaveric study using a total of 16 sides in eight cadavers. Measurements of the STA trunk with its frontal branch (STAfb) were taken before and after skeletonization and detethering of the STA with the STAfb and mobilization of the parietal branch of the STA. A final measurement of the STA with the STAfb was taken for the free length gained toward visible proximal cortical branches of the MCA. Paired student's <jats:italic>t<\/jats:italic>\u2010tests were used to compare the mean length before and after mobilization and unpaired <jats:italic>t<\/jats:italic>\u2010tests to analyze according to laterality. The mean length of the STA with the STAfb was 9.0\u00a0cm prior to modification. After skeletonization and mobilization, the mean lengths increased significantly to 10.5 and 11.3\u00a0cm, respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Especially in the cases that had the coiled and tortuous STA, skeletonization was considerably effective to increase the length of the STA with the STAfb. After simulating a bypass by bringing the STAfb to the recipient MCA site, the mean extended length of the STA with the STAfb was 3.0\u00a0cm. There were no statistically significant differences between sides in all measurements. We report a significant increase in the mean STA length available (3.0\u00a0cm) following skeletonization and mobilization. Clinical applications of the extended length of the STA with the STAfb may facilitate tension\u2010free STA\u2010MCA bypasses and improve outcomes. Further studies are needed in a clinical context.<\/jats:p>","DOI":"10.1002\/ca.23789","type":"journal-article","created":{"date-parts":[[2021,9,25]],"date-time":"2021-09-25T07:33:43Z","timestamp":1632555223000},"page":"428-433","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Detethering the superficial temporal artery: Application to tension free superficial temporal artery<scp>\u2010<\/scp>middle cerebral artery bypasses"],"prefix":"10.1002","volume":"35","author":[{"given":"Mansour","family":"Mathkour","sequence":"first","affiliation":[{"name":"Tulane University and Ochsner Clinic Neurosurgery Program Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Neurosurgery Division, Surgery Department Jazan University School of Medicine  Jazan Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassidy","family":"Werner","sequence":"additional","affiliation":[{"name":"Tulane University and Ochsner Clinic Neurosurgery Program Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Scullen","sequence":"additional","affiliation":[{"name":"Tulane University and Ochsner Clinic Neurosurgery Program Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vernard S.","family":"Fennell","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Ochsner Health System  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Nerva","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter S.","family":"Amenta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joe","family":"Iwanaga","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Department of Neurology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron S.","family":"Dumont","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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Shane","family":"Tubbs","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Ochsner Health System  New Orleans Louisiana USA"},{"name":"Department of Neurosurgery Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Department of Neurology Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Department of Anatomical Sciences St. George's University  True Blue Grenada"},{"name":"Department of Structural and Cellular Biology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(83)90338-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.01.161"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/102.3.635"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3171\/2009.4.JNS081649"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.7461\/jcen.2016.18.3.239"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-02411-0_13"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-197907010-00004"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23671"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3171\/2008.9.JNS17658"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23550"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198506000-00008"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1376189"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3171\/2020.3.JNS192847"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2004.09.041"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-014-2226-2"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1610"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23033"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ons\/opz249"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuchi.2014.03.004"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-018-0966-9"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-197707000-00005"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-011-0238-y"}],"container-title":["Clinical Anatomy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23789","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ca.23789","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T16:22:47Z","timestamp":1692980567000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ca.23789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1002\/ca.23789"],"URL":"https:\/\/doi.org\/10.1002\/ca.23789","archive":["Portico"],"relation":{},"ISSN":["0897-3806","1098-2353"],"issn-type":[{"type":"print","value":"0897-3806"},{"type":"electronic","value":"1098-2353"}],"subject":[],"published":{"date-parts":[[2021,10]]},"assertion":[{"value":"2021-09-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}