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Revascularization and aneurysm surgery: current status.

R F Spetzler, L P Carter

    Neurosurgery
    |January 1, 1985
    PubMed
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    Hunterian ligation is effective for unclippable intracranial aneurysms but carries a high risk of stroke. Extracranial-intracranial bypass grafting (EC-IC) significantly improves safety and should be considered.

    Area of Science:

    • Neurosurgery
    • Vascular Surgery
    • Neurology

    Background:

    • Unclippable intracranial aneurysms pose treatment challenges.
    • Hunterian ligation is a primary treatment but risks cerebral ischemia.
    • Predicting the safety of vessel occlusion is difficult.

    Observation:

    • Stump pressure and cerebral blood flow measurements offer accurate acute assessment.
    • Long-term risks associated with carotid ligation are substantial.
    • Extracranial-intracranial bypass grafting (EC-IC) is a low-risk procedure.

    Findings:

    • EC-IC bypass grafting enhances the safety of parent vessel ligation.
    • Hunterian ligation for intracranial aneurysms necessitates careful risk assessment.

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    Implications:

    • EC-IC bypass grafting should be strongly considered when planning Hunterian ligation.
    • This approach can mitigate the significant risks of cerebral ischemia.
    • Improved patient outcomes are anticipated with the combined technique.