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High flow extra-cranial to intra-cranial bypass for complex internal carotid aneurysms
1Department of Academic Neurosurgery, University of Cambridge, Addenbrookes Hosptial, Cambridge, UK.
British Journal of Neurosurgery
|February 5, 2010
Summary
Extracranial-intracranial (EC-IC) bypass surgery offers a valuable treatment for complex brain aneurysms when other methods fail. This study shows good graft patency and low morbidity, making it a viable option for challenging cases.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Neurology
Background:
- Extracranial-intracranial (EC-IC) bypass is indicated for complex anterior circulation aneurysms unresponsive to parent artery occlusion.
- High-flow bypass techniques are increasingly utilized for these challenging vascular lesions.
Purpose of the Study:
- To evaluate the process and outcomes of high-flow EC-IC bypass in patients with complex anterior circulation aneurysms.
- To report on graft patency, surgical complications, obliteration rates, and patient disposition.
Main Methods:
- A retrospective review of patients undergoing EC-IC bypass for complex anterior circulation aneurysms.
- Analysis of 11 bypass procedures in nine patients.
- Assessment of post-operative imaging for aneurysm obliteration and graft patency.
Main Results:
- Eleven bypasses were performed in nine patients, with seven giant saccular carotid aneurysms successfully obliterated.
- Overall graft patency was 88%, with one instance of graft revision and one subdural collection managed conservatively.
- Eight out of nine patients were discharged home, with no mortality observed.
Conclusions:
- EC-IC bypass is a technically demanding but valuable treatment for complex anterior circulation aneurysms.
- High graft patency rates and low surgical morbidity can be achieved, offering a favorable outcome for patients with poor natural disease history.
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