"Bonnet bypass" using a radial artery interposition graft-how I do it.

ABSTRACT:

Background

Common carotid artery (CCA) occlusion frequently results in compromised hemodynamics of the ipsilateral hemisphere with risk of infarction but also a lack of blood flow in the ipsilateral superficial temporal artery (STA), requiring a more complex revascularization strategy than a standard extracranial-intracranial (EC-IC) bypass when indicated.

Method

We describe the performance of a "Bonnet bypass" using a radial artery interposition graft (RAIG) from the contralateral STA to the ipsilateral middle cerebral artery (MCA). A groove is drilled in the skullcap to position the RAIG and reduce risk of mobilization and compression.

Conclusion

The "Bonnet bypass" enables a revascularization procedure when the ipsilateral STA is not available as donor vessel.

SUBMITTER: Khajuria RK 

PROVIDER: S-EPMC12575573 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature