Tratamiento de un aneurisma serpentino gigante de arteria cerebral media con bypass de alto flujo desde la arteria carótida interna petrosa

Abstract

ResumenSe presenta un caso de aneurisma gigante del segmento M1 de la arteria cerebral media (ACM), de tipo serpentino, tratado mediante bypass de alto flujo con vena safena externa desde la arteria carótida interna petrosa. Se describen los pasos de la cirugía y se destacan las dificultades de la técnica. Se discuten los elementos a considerar en la toma de decisiones para la indicación, diseño y realización del bypass en el tratamiento de los aneurismas de la ACM.PALABRAS CLAVE. Aneurisma cerebral gigante. Aneurisma serpentino, Arteria carótida interna petrosa. Bypass intra-intracraneal.Treatment of a giant serpentine type middle cerebral artery aneurysm with a high-flow bypass from the petrous internal carotid artery Summary A case report of a giant serpentine type aneurysm arising from the M1 segment of the middle cerebral artery (MCA) treated with a high-flow external saphenous vein graft from the petrous segment of the internal carotid artery is presented. The steps and challenges of this demanding surgical technique are also described. The elements to be taken into consideration in the indication, design and realization of the bypass surgery in the treatment of the MCA aneurysms are discused.KEY WORDS. Giant cerebral aneurysm. Serpentine aneurysm. Petrous internal carotid artery. Intracranial-intracranial bypass IntroducciónEl bypass es una técnica alternativa a la exclusión directa con clipaje microquirúrgico de los aneurismas cerebrales gigantes 1,3,4,6,8,10,13