Giant intracranial aneurysm surgery: The role of microvascular reconstruction

Ausman, James I.; Díaz, Fernando G.; Sadasivan, Balaji; Gonzeles-Portillo, Marco; Malik, Ghaus M.; Deopujari, Chandrashekhar

doi:10.1016/0090-3019(90)90166-m

Cited by 60 publications

(19 citation statements)

References 22 publications

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“…2,3,[9][10][11][12] Although anterior circulation aneurysms distal to the ACoA and proximal to the CMA-PerA bifurcation are relatively rare, 6,7 this technique may also be applicable to complex aneurysms of the A 1 segment, the A 1 -A 2 junction, or the ACoA complex. Nevertheless, factors such as previous clip placement, a broad-based aneurysm neck, circumferential parent vessel involvement of the lesion, and a location distal to the ACoA rendered single-therapy treatment untenable in this case.…”

Section: Discussionmentioning

confidence: 99%

Combined surgical and endovascular treatment of a recurrent A3–A3 junction aneurysm unsuitable for standalone clip ligation or coil occlusion

Kim

Albuquerque

McDougall

et al. 2005

FOC

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Recurrent aneurysms of the anterior circulation that are distal to the anterior communicating artery (ACoA) but proximal to the callosomarginal–pericallosal bifurcation can pose a treatment challenge. The authors present one such case, in which the patient was treated with pericallosal artery–pericallosal artery (PerA–PerA) side-to-side bypass, followed by endovascular obliteration of the proximal A2 parent vessel. This patient, in whom an ACoA aneurysm had been treated with clip ligation 5 years previously, presented with a new, mid-A2, right-sided aneurysm with the out-flow artery arising from the dome of the lesion. The treatment plan included two steps: an interhemispheric transcallosal approach for PerA–PerA side-to-side anastomosis; and endovascular coil embolization of the right A2 branch feeding the aneurysm. Postprocedure angiography demonstrated no ipsilateral aneurysm filling and excellent bilateral distal outflow from the anterior cerebral artery (ACA). The use of PerA–PerA side-to-side bypass for the treatment of an ACA aneurysm, followed by parent vessel occlusion, offers an elegant solution for the treatment of A2 aneurysms that are not amenable to stand-alone clip ligation or coil occlusion. Such combined methods are invaluable in the management of complex cerebral aneurysms.

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Section: Discussionmentioning

confidence: 99%

Combined surgical and endovascular treatment of a recurrent A3–A3 junction aneurysm unsuitable for standalone clip ligation or coil occlusion

Kim

Albuquerque

McDougall

et al. 2005

FOC

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“…Table 1 shows baseline study data, patient characteristics, and outcome for each study eligible for inclusion in the review. [73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88] The median number of patients per trial was 21 (range, 4-61). The mean age of the patients was 59 years (range, .…”

Section: Included Trials Case Series and Subjectsmentioning

confidence: 99%

Extracranial-Intracranial Bypass to Reduce the Risk of Ischemic Stroke in Intracranial Aneurysms of the Anterior Cerebral Circulation: A Systematic Review

Schaller

2008

Journal of Stroke and Cerebrovascular Diseases

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“…Bypass surgery for CBF replacement is most frequently performed in complex aneurysm surgery, such as when an aneurysm is trapped, or in skull base tumor surgery associated with vessel sacrifice or injury. 5,7,23,34,35,43,46,47,51,72 Multiple mechanisms of creating artificial CBF conduits are available in addition to the already discussed pedicled arterial graft of the STA-MCA anastomosis. An STA-MCA bypass has a patency rate of > 95%.…”

Section: Present Practicesmentioning

confidence: 99%

The evolution of cerebral revascularization surgery

Hayden¹,

Lee²,

Guzman³

2009

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Among the relatively few surgeons to be awarded the Nobel Prize was Alexis Carrel, a French surgeon and pioneer in revascularization surgery at the turn of the 20th century. The authors trace the humble beginnings of cerebral revascularization surgery through to the major developments that helped shape the modern practice of cerebral bypass surgery. They discuss the cornerstone studies in the development of this technique, including the Extracranial/Intracranial Bypass Study initiated in 1977. Recent innovations, including modern techniques to monitor cerebral blood flow, microanastomosis techniques, and ongoing trials that play an important role in the evolution of this field are also evaluated.

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Giant intracranial aneurysm surgery: The role of microvascular reconstruction

Cited by 60 publications

References 22 publications

Combined surgical and endovascular treatment of a recurrent A3–A3 junction aneurysm unsuitable for standalone clip ligation or coil occlusion

Combined surgical and endovascular treatment of a recurrent A3–A3 junction aneurysm unsuitable for standalone clip ligation or coil occlusion

Extracranial-Intracranial Bypass to Reduce the Risk of Ischemic Stroke in Intracranial Aneurysms of the Anterior Cerebral Circulation: A Systematic Review

The evolution of cerebral revascularization surgery

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