The use of a single recipient artery clip for superficial temporal artery to middle cerebral artery bypass in Moyamoya disease: technical tips and considerations

Moyamoya disease is a chronic cerebrovascular disorder causing stenosis and occlusion of terminal intracranial carotid arteries. Direct revascularization via superficial temporal artery to middle cerebral artery bypass can restore cerebral perfusion but it is challenging due to small, fragile recipient vessels. We illustrate our superficial temporal artery to middle cerebral artery bypass technique using a single curved microclip for temporary occlusion of the recipient vessel. Using a single curved clip for temporary occlusion of the recipient vessel can help to overcome technical challenges posed by vessel fragility and loosely positioned recipients.