Microsurgical Management of Giant Intracranial Aneurysms

Sanai, Nader; Lawton, Michael T.

doi:10.1016/b978-1-4160-5316-3.00381-6

Cited by 3 publications

(1 citation statement)

References 88 publications

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“…Revascularization procedures or bypass techniques are useful to prevent cerebral ischemia caused by prolonged temporary occlusion during clipping of large or giant aneurysms. 21,22 This is especially the case with complex aneurysms, in which clipping may require prolonged temporary or permanent occlusion of the parent vessel. 23 In our series, none of the patients developed bypass-related complications.…”

Section: Bypass Procedures For Large or Giant Aneurysmsmentioning

confidence: 99%

Retrograde Suction Decompression for Clip Occlusion of Internal Carotid Artery Communicating Segment Aneurysms

et al. 2016

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Section: Bypass Procedures For Large or Giant Aneurysmsmentioning

confidence: 99%

Retrograde Suction Decompression for Clip Occlusion of Internal Carotid Artery Communicating Segment Aneurysms

et al. 2016

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Tailored flow sequestration treatment using high-flow and low-flow bypass for partially thrombosed giant internal carotid artery aneurysm—a technical case report

Hasegawa¹,

Inoue²,

Tamura³

et al. 2016

Neurosurg Rev

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Direct clipping of giant partially thrombosed intracranial internal carotid artery (ICA) aneurysms is challenging, especially when important perforating arteries are involved. Proximal occlusion with bypass represents a possible alternative approach. An 80-year-old female presented with worsening visual acuity and severe headache caused by partially thrombosed giant (38 mm in diameter) aneurysms of the right ICA, suggestive of impending rupture. Direct clipping in conjunction with temporary occlusion of the lesion involving the anterior choroidal artery (AChA) was considered too risky. Thus, we sequestrated the ipsilateral ICA flow into a low-flow and a high-flow system using two external carotid artery (ECA)-ICA bypasses and one in situ bypass with cervical ICA ligation. As a result, the low-flow system by the superficial temporal artery-middle cerebral artery (MCA) bypass perfused mainly the proximal MCA lesions and aneurysm, whereas the high-flow system by ECA-radial artery-M2 bypass exclusively supplied the residual distal MCA area. This tailored flow sequestration successfully interrupted intra-aneurysmal flow and accelerated near-complete thrombosis of the aneurysm while preserving the AChA and avoiding any significant neurological deterioration. We conclude that this method is effective for the management of giant partially thrombosed aneurysms of the ICA, especially when direct clipping is difficult.

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Treatment of Giant Intracranial Aneurysms: a Review Based on Experience from 286 Cases

Sousa

Filho

2015

Arq Bras Neurocir

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Aneurysms are classified as giant when their largest diameter is equal to or greater than 25?mm, which represents approximately 5?7% of intracranial aneurysms. Severe disease with poor natural history presents with 68% mortality in two years and 85% in five years for untreated cases. Thus, in the majority of cases, the patients require treatment, despite the risks of therapeutic options. We discuss the epidemiology, natural history, diagnosis, and treatment of giant aneurysms based on the experience of 286 operations and literature data.

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Microsurgical Management of Giant Intracranial Aneurysms

Cited by 3 publications

References 88 publications

Retrograde Suction Decompression for Clip Occlusion of Internal Carotid Artery Communicating Segment Aneurysms

Retrograde Suction Decompression for Clip Occlusion of Internal Carotid Artery Communicating Segment Aneurysms

Tailored flow sequestration treatment using high-flow and low-flow bypass for partially thrombosed giant internal carotid artery aneurysm—a technical case report

Treatment of Giant Intracranial Aneurysms: a Review Based on Experience from 286 Cases

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