A modified technique to bypass the maxillary artery to supraclinoid internal carotid artery by using radial artery graft: an anatomical study

Objective: This study aims to examine the use of a radial artery graft for bypass of the maxillary artery (MA) to the supraclinoid internal carotid artery (ICA) in treating ICA occlusions. Study design and setting: This method was carried out on five adult cadaver sides. The MA was reached 1-2 cm inferior to the crista infratemporalis, following a frontotemporal craniotomy and a zygomatic arch osteotomy. Extradurally 2-3 cm lateral to the foramen rotundum, a hole was drilled in the sphenoid bone with a 4 mm tipped drill. A radial artery graft was passed through the hole to the inside of the dura. Before giving the infraorbital artery branch, the MA was dissected from the surrounding tissue and transected. The proximal end of the graft was anastomosed end-to-end with the MA and the distal end of the graft end-to-side with the supraclinoid ICA. Results: The mean calibre of the MA was 2.6 +/- 0.3 mm. The mean calibre of the proximal end of the radial artery graft was 2.5 +/- 0.25 mm and the distal end was 2.35 +/- 0.2 mm. The mean length of the radial artery graft was 4.0 +/- 0.5cm. Conclusion: This study suggested that the cases with ICA occlusion, which require high blood flow, may be treated as an alternative to current bypass methods requiring long vein grafts.