{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T19:08:47Z","timestamp":1779044927916,"version":"3.51.4"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Superficial temporal artery (STA)\u2013middle cerebral artery (MCA) bypasses have continually evolved, and new strategies have been advocated for reducing anesthetic or surgical morbidity and mortality. Further simplifying, and decreasing the invasiveness of, STA-MCA bypass by performing this operation without endotracheal general anesthesia was believed to be feasible in certain subsets of patients.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors performed STA-MCA bypass using local anesthesia with a sedative in 10 patients with hemodynamically compromised occlusive cerebrovascular disease, as well as multiple comorbidities, between February 2010 and September 2011. The technique is based on the preoperative identification of the point at which the donor and recipient vessels are in closest proximity. Preoperative use of CT angiography allowed the authors to identify the target point precisely and use a minimally invasive procedure. All patients received dexmedetomidine as the sole sedative agent, together with scalp-blocking local anesthesia, with an unsecured airway.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Successful STA-MCA bypass surgeries were achieved via a preselected minimally invasive approach in all cases. There was good hemodynamic stability throughout surgery. No airway or ventilation complications occurred, and no patients were converted to general anesthesia. Subjectively, patients tolerated the technique well with a high rate of satisfaction. There were no perioperative morbidities or deaths. Postoperative MR angiography confirmed a patent bypass in all patients. All patients remained symptom free and returned to normal daily life following the operation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This initial experience confirms the feasibility of performing STA-MCA bypass without endotracheal general anesthesia. This novel technique produced a high degree of patient satisfaction.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.4.jns111958","type":"journal-article","created":{"date-parts":[[2012,5,25]],"date-time":"2012-05-25T13:58:45Z","timestamp":1337954325000},"page":"288-294","source":"Crossref","is-referenced-by-count":13,"title":["Superficial temporal artery\u2013middle cerebral artery bypass using local anesthesia and a sedative without endotracheal general anesthesia"],"prefix":"10.3171","volume":"117","author":[{"given":"Yasuhiko","family":"Kaku","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Yamashita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jouji","family":"Kokuzawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyomitsu","family":"Kanou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Tsujimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns111958","series-title":"Stroke","first-page":"1175","article-title":"Conscious sedation versus general anesthesia during endovascular therapy for acute anterior circulation stroke: preliminary results from a retrospective, multicenter study","volume":"41","author":"Abou-Chebl","year":"2010"},{"key":"b2-jns111958","series-title":"Curr Opin Anaesthesiol","first-page":"560","article-title":"\u2018Anesthesia\u2019 for awake neurosurgery","volume":"22","author":"Bilotta","year":"2009"},{"key":"b3-jns111958","series-title":"J Neurosurg","first-page":"553","article-title":"Minimally invasive superficial temporal artery to middle cerebral artery bypass through an enlarged bur hole: the use of computed tomography angiography neuronavigation in surgical planning. Technical note","volume":"109","author":"Coppens","year":"2008"},{"issue":"5","key":"b4-jns111958","series-title":"Neurosurg Focus","first-page":"E20","article-title":"Minimally invasive superficial temporal artery to middle cerebral artery bypass through a minicraniotomy: benefit of three-dimensional virtual reality planning using magnetic resonance angiography","volume":"26","author":"Fischer","year":"2009"},{"key":"b5-jns111958","series-title":"Trials","first-page":"28","article-title":"GALA: an international multicentre randomised trial comparing general anaesthesia versus local anaesthesia for carotid surgery","volume":"9","author":"Gough","year":"2008"},{"key":"b6-jns111958","series-title":"Circulation","first-page":"e154","article-title":"ACC\/AHA 2005 Guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"112","author":"Hunt","year":"2005"},{"key":"b7-jns111958","series-title":"Stroke","first-page":"1180","article-title":"Comparison of safety and clinical and radiographic outcomes in endovascular acute stroke therapy for proximal middle cerebral artery occlusion with intubation and general anesthesia versus the nonintubated state","volume":"41","author":"Jumaa","year":"2010"},{"key":"b8-jns111958","series-title":"13th European Congress of Neurosurgery","first-page":"527","article-title":"Less invasive technique for EC-IC bypass","author":"Kaku","year":"2007"},{"key":"b9-jns111958","series-title":"Acta Neurochir Suppl","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/978-3-211-76589-0_15","article-title":"Less invasive technique for EC-IC bypass","volume":"103","author":"Kaku","year":"2008"},{"key":"b10-jns111958","series-title":"Ann Thorac Surg","first-page":"91","article-title":"Coronary artery bypass grafting in the conscious patient without endotracheal general anesthesia","volume":"70","author":"Karag\u00f6z","year":"2000"},{"key":"b11-jns111958","series-title":"Anesth Analg","first-page":"791","article-title":"High thoracic epidural anesthesia for coronary artery bypass grafting using two different surgical approaches in conscious patients","volume":"95","author":"Kessler","year":"2002"},{"key":"b12-jns111958","series-title":"J Neurosurg","first-page":"1056","article-title":"Patients' perceptions of awake and outpatient craniotomy for brain tumor: a qualitative study. Clinical article","volume":"112","author":"Khu","year":"2010"},{"issue":"6 Suppl 3","key":"b13-jns111958","series-title":"Neurosurgery","first-page":"1434","article-title":"\u201cTarget Bypass\u201d: a method for preoperative targeting of a recipient artery in superficial temporal artery-to-middle cerebral artery anastomoses","volume":"62","author":"Kikuta","year":"2008"},{"key":"b14-jns111958","series-title":"Anadolu Kardiyol Derg","first-page":"54","article-title":"Epidural anesthesia versus general anesthesia in patients undergoing minimally invasive direct coronary artery bypass surgery","volume":"9","author":"Kurto\u011flu","year":"2009"},{"key":"b15-jns111958","series-title":"J Clin Anesth","first-page":"490","article-title":"Adjuvant bupivacaine scalp block facilitates stabilization of hemodynamics in patients undergoing craniotomy with general anesthesia: a preliminary report","volume":"18","author":"Lee","year":"2006"},{"key":"b16-jns111958","series-title":"Eur J Cardiothorac Surg","first-page":"658","article-title":"Coronary artery bypass grafting in the awake patient: combined thoracic epidural and lumbar subarachnoid block","volume":"26","author":"Lucchetti","year":"2004"},{"key":"b17-jns111958","series-title":"Br J Anaesth","first-page":"184","article-title":"Coronary artery bypass grafting in the awake patient combining high thoracic epidural and femoral nerve block: first series of 15 patients","volume":"100","author":"Noiseux","year":"2008"},{"key":"b18-jns111958","series-title":"Am J Respir Crit Care Med","first-page":"1256","article-title":"Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI\/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary","volume":"163","author":"Pauwels","year":"2001"},{"key":"b19-jns111958","series-title":"A review BMJ","first-page":"1493","article-title":"Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials","volume":"321","author":"Rodgers","year":"2000"},{"key":"b20-jns111958","series-title":"Anesth Analg","first-page":"882","article-title":"Anesthetic complications of awake craniotomies for epilepsy surgery","volume":"102","author":"Skucas","year":"2006"},{"key":"b21-jns111958","series-title":"J Neurosurg Anesthesiol","first-page":"38","article-title":"Dexmedetomidine sedation during awake craniotomy for seizure resection: effects on electrocorticography","volume":"19","author":"Souter","year":"2007"},{"key":"b22-jns111958","series-title":"Crit Care Med","first-page":"1007","article-title":"Bispectral index-guided sedation with dexmedetomidine in intensive care: a prospective, randomized, double blind, placebo-controlled phase II study","volume":"30","author":"Triltsch","year":"2002"},{"key":"b23-jns111958","series-title":"Interact Cardiovasc Thorac Surg","first-page":"910","article-title":"Awake subxyphoid minimally invasive direct coronary artery bypass grafting yielded minimum invasive cardiac surgery for high risk patients","volume":"7","author":"Watanabe","year":"2008"},{"key":"b24-jns111958","series-title":"Microsurgery Applied to Neurosurgery","first-page":"105","author":"Ya\u015fargil","year":"1969"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/117\/2\/article-p288.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/117\/2\/article-p288.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/117\/2\/article-p288.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T23:21:19Z","timestamp":1679872879000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/117\/2\/article-p288.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,8]]},"references-count":24,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2012.4.jns111958","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,8]]}}}