To explore the application of superficial temporal artery-middle cerebral artery (STA-MCA) bypass operation in chronic intracranial ischemic diseases and analyze the short-term safety after single/double STA-MCA end-to-side anastomosis.

The clinical data of patients with chronic internal carotid artery occlusion treated by end-to-side anastomosis involving STA-MCA in the Department of Neurosurgery of Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital from January to August 2020 were retrospectively analyzed. According to the treatment methods, the patients were divided into single bypass group and double bypass group. The statistical differences of complications such as cerebral hyperperfusion syndrome, bridge occlusion, intracranial infection and scalp necrosis in the short term after operation between the two groups were analyzed.

A total of 35 patients underwent 41 operations, including 25 single bypass and 16 double bypass. There was no significant difference in clinical data between the two groups before operation (P>0.05). And there was no statistically significant difference neither in the rate of high perfusion response postoperative (20% in the single-branch group and 44% in the double-branch group, P=0.103) nor the rate of Bridge-vessel occlusion (8% vs 6%, P=0.834) in the CTA for 7 d after the operation. No patients in the two groups showed infection or scalp necrosis after operation.

Through this study, there is no evidence that double bypass may increase the risk of surgery. However, the cerebral blood flow after double-bypass is more obvious increase than that after single-bypass, which will be further quantified in future studies to evaluate the clinical significance of this operation.