Extracranial⁃intracranial bypass for giant intracranial aneurysms

Objective To report bypass treatment for 6 cases of giant intracranial aneurysm, and discuss the surgical indication and therapeutic effect. Methods A series of 6 patients with giant intracranial aneurysm underwent extracranial ⁃ intracranial bypass. Pre ⁃ operative cerebral hemodynamics, mode of by...

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Main Authors: Zhen⁃hua HUANG, Dong ZHANG, Shuo WANG, Rong WANG, Ji⁃zong ZHAO
Format: Article
Language:English
Published: Tianjin Huanhu Hospital 2012-02-01
Series:Chinese Journal of Contemporary Neurology and Neurosurgery
Subjects:
Online Access:http://www.cjcnn.org/index.php/cjcnn/article/view/109
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author Zhen⁃hua HUANG
Dong ZHANG
Shuo WANG
Rong WANG
Ji⁃zong ZHAO
author_facet Zhen⁃hua HUANG
Dong ZHANG
Shuo WANG
Rong WANG
Ji⁃zong ZHAO
author_sort Zhen⁃hua HUANG
collection DOAJ
description Objective To report bypass treatment for 6 cases of giant intracranial aneurysm, and discuss the surgical indication and therapeutic effect. Methods A series of 6 patients with giant intracranial aneurysm underwent extracranial ⁃ intracranial bypass. Pre ⁃ operative cerebral hemodynamics, mode of bypass, and the clinical and imaging outcomes were analysed. Results Among 6 patients, 3 patients underwent trapping and resection (or parent vessel reconstruction) combined with low⁃flow bypass while the other 3 patients underwent clipping (or trapping) combined with high⁃flow bypass (external carotid artery⁃radial artery/great saphenous vein⁃middle cerebral artery bypass). The follow⁃up period ranged from 6 to 28 months (mean 17 months). The short⁃term and long⁃term cerebral aniography and CT angiography showed the bypass vessel and anastomotic stoma were all patent. Signs and symptoms were improved in different degree. During follow ⁃ up period, no acute hemorrhagic or ischemic cerebrovascular events occurred. Among 3 patients who underwent combined low ⁃ flow bypass, the long ⁃ term modified Rankin Scale (mRS) was 0 in 2 patients and 2 in one patient. Among the other 3 patients who underwent combined high⁃flow bypass, the long⁃term mRS was 0 in one and 1 in 2 patients. Conclusion Surgical treatment for complex intracranial aneurysm may sacrifice the parent vessel or the distal MCA branches. It is according to the patients condition and different intracranial ⁃ extracranial vascular bypass which may effectively preserve the blood flow. Perfusion CT in combination with digital subtraction angiography can be used to evaluate distal perfusion status and collateral circulation in patients with giant intracranial aneurysm. DOI:10.3969/j.issn.1672⁃6731.2012.01.009
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spelling doaj.art-f5bb1ab5e2464744a4febf7e661148422022-12-21T18:53:23ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312012-02-011213743108Extracranial⁃intracranial bypass for giant intracranial aneurysmsZhen⁃hua HUANGDong ZHANGShuo WANGRong WANGJi⁃zong ZHAOObjective To report bypass treatment for 6 cases of giant intracranial aneurysm, and discuss the surgical indication and therapeutic effect. Methods A series of 6 patients with giant intracranial aneurysm underwent extracranial ⁃ intracranial bypass. Pre ⁃ operative cerebral hemodynamics, mode of bypass, and the clinical and imaging outcomes were analysed. Results Among 6 patients, 3 patients underwent trapping and resection (or parent vessel reconstruction) combined with low⁃flow bypass while the other 3 patients underwent clipping (or trapping) combined with high⁃flow bypass (external carotid artery⁃radial artery/great saphenous vein⁃middle cerebral artery bypass). The follow⁃up period ranged from 6 to 28 months (mean 17 months). The short⁃term and long⁃term cerebral aniography and CT angiography showed the bypass vessel and anastomotic stoma were all patent. Signs and symptoms were improved in different degree. During follow ⁃ up period, no acute hemorrhagic or ischemic cerebrovascular events occurred. Among 3 patients who underwent combined low ⁃ flow bypass, the long ⁃ term modified Rankin Scale (mRS) was 0 in 2 patients and 2 in one patient. Among the other 3 patients who underwent combined high⁃flow bypass, the long⁃term mRS was 0 in one and 1 in 2 patients. Conclusion Surgical treatment for complex intracranial aneurysm may sacrifice the parent vessel or the distal MCA branches. It is according to the patients condition and different intracranial ⁃ extracranial vascular bypass which may effectively preserve the blood flow. Perfusion CT in combination with digital subtraction angiography can be used to evaluate distal perfusion status and collateral circulation in patients with giant intracranial aneurysm. DOI:10.3969/j.issn.1672⁃6731.2012.01.009http://www.cjcnn.org/index.php/cjcnn/article/view/109Intracranial aneurysmSubarachnoid hemorrhageCerebral revascularization
spellingShingle Zhen⁃hua HUANG
Dong ZHANG
Shuo WANG
Rong WANG
Ji⁃zong ZHAO
Extracranial⁃intracranial bypass for giant intracranial aneurysms
Chinese Journal of Contemporary Neurology and Neurosurgery
Intracranial aneurysm
Subarachnoid hemorrhage
Cerebral revascularization
title Extracranial⁃intracranial bypass for giant intracranial aneurysms
title_full Extracranial⁃intracranial bypass for giant intracranial aneurysms
title_fullStr Extracranial⁃intracranial bypass for giant intracranial aneurysms
title_full_unstemmed Extracranial⁃intracranial bypass for giant intracranial aneurysms
title_short Extracranial⁃intracranial bypass for giant intracranial aneurysms
title_sort extracranial⁃intracranial bypass for giant intracranial aneurysms
topic Intracranial aneurysm
Subarachnoid hemorrhage
Cerebral revascularization
url http://www.cjcnn.org/index.php/cjcnn/article/view/109
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AT dongzhang extracranialintracranialbypassforgiantintracranialaneurysms
AT shuowang extracranialintracranialbypassforgiantintracranialaneurysms
AT rongwang extracranialintracranialbypassforgiantintracranialaneurysms
AT jizongzhao extracranialintracranialbypassforgiantintracranialaneurysms