Dissection of superficial temporal artery for STA-M4 bypass, an integrated method. How I do it

BACKGROUND: Extracranial-intracranial (EC-IC) bypass is an effective revascularization technique for flow augmentation in conditions including Moyamoya disease and ischemic cerebrovascular disorders. Preparation of donor vessel is a key step for EC-IC Bypass surgery. This procedure involves careful dissection and liberation of the Superficial Temporal Artery with subsequent anastomosis to branches of the middle cerebral artery re-establishing flow. METHODS: This article outlines a comprehensive surgical strategy, emphasizing anatomical considerations, procedural nuances, and integration of different schools of dissection with video demonstration making it didactically efficient. CONCLUSION: Combined technique for STA dissection is fast, effective and ideal to avoid complications or adverse events.