Figure 5.
Summary of Phase 1 surgical management (STA to SCA or PCA bypass), with (A) harvest of donor STA, (B) exposure through an orbitozygomatic-pterional craniotomy, (C) exposure and access to recipient SCA or PCA subtemporally or pretemporally, (D) completion of the EC-IC anastomosis (STA to SCA bypass shown), and endovascular occlusion of the vertebral arteries bilaterally in a separate procedural stage. Abbreviations: ICA = internal carotid artery; A1 = anterior cerebral artery, A1 segment; M1 = middle cerebral artery, M1 segment; BA = basilar artery; VA = vertebral artery; PICA = posterior inferior cerebellar artery; STA = superficial temporal artery; SylV = Sylvian vein; II = optic nerve; III = oculomotor nerve.