Submandibular-infratemporal interpositional carotid artery bypass for cranial base tumors and giant aneurysms

Cerebral revascularization is an important strategy in the surgical management of some complex cranial base tumors and unclippable aneurysms. A highflow bypass may be necessary in planned carotid occlusion or sacrifice. The cervical-to-supraclinoid internal carotid artery bypass or cervical carotid-to-middle cerebral artery bypass are useful procedures to bypass lesions at the base of the cranium. We describe technical modifications of the submandibular-infratemporal interpositional saphenous vein (or radial artery) graft bypass technique specifically designed to avoid removal of the zygoma.