Skip to main content
Top
Published in: Neurosurgical Review 1/2024

01-12-2024 | Aneurysm | Research

In situ interposition bypass for complex intracranial aneurysms: A single-center experience and efficacy analysis

Authors: Meng Zhang, Xingdong Wang, Xiaoguang Tong

Published in: Neurosurgical Review | Issue 1/2024

Login to get access

Abstract

The purpose of this study was to investigate the application and efficacy analysis of in situ interposition bypass in complex intracranial aneurysms. This study retrospectively analyzed the clinical data of 21 patients with complex intracranial aneurysms treated with in situ interposition bypass grafting in the Department of Neurosurgery at Tianjin Huanhu Hospital from June 2015 to December 2022. The aneurysms were located in the middle cerebral artery in 16 cases, the anterior cerebral artery in 3 cases, the posterior cerebral artery in 1 case, and the posterior inferior cerebellar artery in 1 case. The interposition graft vessels were taken from the radial artery in 15 cases, the superficial temporal artery in 5 cases, and the occipital artery in 1 case. All patients underwent end-to-end anastomosis with in situ interposition bypass after aneurysm resection, including 13 cases of "I-shaped" type, 5 cases of "V-shaped" type, and 3 cases of "Y-shaped" type. Postoperative digital subtraction angiography (DSA) or computed tomography angiography (CTA) reviews were performed for all the patients, and modified Rankin Scale (mRS) score was used to assess patient prognosis. Three patients developed postoperative basal ganglia infarction and two of them recovered well. One case developed transient incomplete aphasia and one case developed mild hemiparesis, which recovered well after 3 months. The remaining 16 patients did not develop new neurological deficits. Postoperative DSA or CTA showed that the anastomosis of the bypass graft and the graft vessels were patent, and all aneurysms were completely eliminated. Regular postoperative follow-up ranged from 3 to 89 months, and no aneurysm recurred. The percentage of patients with mRS ≤ 2 at the final follow-up was 90.5%. Based on the experience of surgical treatment in our center, in situ interposition bypass technique is a safe and effective option for the treatment of some complex intracranial aneurysms.
Literature
20.
go back to reference Matsukawa H, Tanikawa R, Kamiyama H et al (2017) Graft occlusion and graft size changes in complex internal carotid artery aneurysm treated by extracranial to intracranial bypass using high-flow grafts with therapeutic internal carotid artery occlusion. Neurosurgery 81(4):672–679. https://doi.org/10.1093/neuros/nyx075CrossRefPubMed Matsukawa H, Tanikawa R, Kamiyama H et al (2017) Graft occlusion and graft size changes in complex internal carotid artery aneurysm treated by extracranial to intracranial bypass using high-flow grafts with therapeutic internal carotid artery occlusion. Neurosurgery 81(4):672–679. https://​doi.​org/​10.​1093/​neuros/​nyx075CrossRefPubMed
Metadata
Title
In situ interposition bypass for complex intracranial aneurysms: A single-center experience and efficacy analysis
Authors
Meng Zhang
Xingdong Wang
Xiaoguang Tong
Publication date
01-12-2024
Publisher
Springer Berlin Heidelberg
Published in
Neurosurgical Review / Issue 1/2024
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI
https://doi.org/10.1007/s10143-023-02266-z

Other articles of this Issue 1/2024

Neurosurgical Review 1/2024 Go to the issue