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Question about STA-MCA bypass (Read 2792 times)

nopi98

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With God....all things
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Pickens, USA, usa, 431, 202, SC, South_Carolina
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Question about STA-MCA bypass
Feb 5^th, 2009 at 11:22am

For those of you know me: Hello again!! For those of you who dont: Its nice to meet you!!

Quick question...I recently had the STA-MCA bypass on both sides of my head performed by Dr. Daniel Barrow at Emory Medical in Atlanta. I asked him what exactly was done (b/c I wanted to know if he actually "bypassed" my blocked artery). Basically I was told that when he went inside my skull he simply was looking for an artery that matched the size of the STA that he was placing inside my head. Now what I want to know is: is that the purpose of this? Because as I see it...bypass means they are actually bypassing a blockage of some sort. But when explained to me, it didnt seem like thats what was happening at all. The surgery was merely to replenish bloodflow into the brain. Which that part I get, but I was also under the belief that they were, again bypassing a blockage. Can someone possibly straighten me out here? Because it seems to me that if he didnt actually bypass my blockage by grafting the STA onto the blocked artery then I'm still stuck with the same MM problem but with more blood flow into my brain.

Thank you all for your time in looking at this and responding.

You are all in my prayers...no matter who you are. Prayer is just one of those things in life (for me anyway) that you cant get too much of or do too much of. Every one helps. Remember...its not "when all else fails try prayer"...it SHOULD be "before all else fails, try prayer". God is with us...no matter where we go or where we are. He listens...I know He does.

Jesus died for us...the very least we could do is live for Him.

Under His authority,

Fred

He died for us...the least we can do is live for Him.

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KTiller

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Freeland, USA, usa, 51, 28, WA, Washington
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Re: Question about STA-MCA bypass
Reply #1 - Feb 7^th, 2009 at 8:08pm

Hi Fred,
Glad to hear your're through the surgery. Some doctor's just don't seem to have the knack of putting explanations into terms that most of us can understand.
You're right in thinking that the STA/MCA by-pass is a by-pass of the blockage. Think of it this way, the blockage is within and or near the circle-of-willis, that's the quarter-sized, traffic circle (or round-about) of arteries at the base of the brain. Blood hits the blockage there and can't flow up into the rest of the brain, so oxygen deprivation occurs and brain cells die (stroke). The MCA (Middle Cerebral Artery) extends from the Circle-of-Willis at the base of the brain, up through the brain and then near to the surface of the scalp. What the STA/MCA bypass does is to take a scalp artery, the STA (Super Temporal Artery) and connect it into the STA at that point where it is near to the scalp (much easier to reach it there than deep with in the brain). The surgeon hopes to find a large scalp artery so that he can ensure a greater blood flow, he then makes a small opening into the side of the MCA and grafts the end of the STA to it. Now, blood is flowing through your brain from the top of the head down into the brain as well as the little bit that is flowing from the usual route, up from the base of the brain then into brain. The two blood flows through the MCA are stopped at either side of the blockage. That's my understanding of it anyways.
My worry was what happens if the blockage should suddenly disappear - would the two flows crash into one another? Huh

I was told that they have NEVER seen the blockage disappear, so one less worry.
Kim

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Mar

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Re: Question about STA-MCA bypass
Reply #2 - Feb 8^th, 2009 at 10:14pm

Hi Fred,

To be honest with you, I’m not exactly sure what you’re asking, because you basically explained the direct bypass and it’s purpose. So, if you get that, I’m not exactly sure what you want to know or how to explain it better to you. A bypass by definition is simply an alternate route, right? So your doctor took an alternate route to replenish the blood supply to your brain, that you were NOT getting because of your MMD. He took a scalp artery and attached it to an artery on the surface of the brain. So now this alternate blood supply (bypass) replenishes your brain with oxygen and nutrients that you desperately needed to avoid a stroke. It does not cure you of the disease. The arteries originally occluded from your MM are still blocked, but now you are getting an alternate blood supply, but by another route. It all clicked for me when I studied the anatomy of the brain and the blood supply to it. There are so many tree like branches that connect and bring blood to the entire aspect of each hemisphere.

Perhaps this explanation and view will help you better understand it all:
http://www.mindsci-clinic.com/ventral_view.htm

I hope this helped.

Mar

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nopi98

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With God....all things
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Pickens, USA, usa, 431, 202, SC, South_Carolina
Gender: male

Re: Question about STA-MCA bypass
Reply #3 - Feb 9^th, 2009 at 9:29am

Good morning all:

Thank you Kim and Mar for your answers...they did help.

Mar: What I was trying to get at was....When I think of bypass, I meant since bloodflow was stopped by a blockage at whatever point it has occurred, it seems to me that in order to bypass it, the STA would have to have been grafted on a section of the same artery that had been blocked...just at some point after the blockage...in order to "bypass" it. But what you guys have explained makes sense as well...I just never thought of it in that perspective. Yet another reason this site is so great.

God bless you all...

Under His authority,

Fred

He died for us...the least we can do is live for Him.

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KTiller

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Freeland, USA, usa, 51, 28, WA, Washington
Gender: female

Re: Question about STA-MCA bypass
Reply #4 - Feb 9^th, 2009 at 3:20pm

Mar, that's a great diagram of the brain. Thanks for posting the link.

Fred,
Like Mar said your basic understanding of the by-pass was right on, in that the surgery does by-pass the blockage. I guess when we think of a hi-way by-pass or a heart by-pass we do think of getting around a blockage but still traveling in the same direction the traffic or blood had been heading. If engineers did a traffic by-pass in the same manner that the surgeon does the STA/MCA by-pass, we'd have head on collisions for sure. I think that the reason they don't do the graft just beyond the blockage is that it is so very dangerous, if not impossible, to perform surgery in that part off the brain. But the surface of the brain, no brainer, given and extremely skilled and experience neurosurgeon and support team Wink

.
Kim

« Last Edit: Feb 9^th, 2009 at 3:25pm by KTiller »

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