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Related Experiment Videos

Revascularization and aneurysm surgery: current techniques, indications, and outcome

M T Lawton1, M G Hamilton, J J Morcos

  • 1Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.

Neurosurgery
|January 1, 1996
PubMed
Summary

Cerebral revascularization is a safe and effective treatment for complex aneurysms requiring parent vessel occlusion. This procedure offers good outcomes with low morbidity and mortality, making it favorable over the risks of untreated aneurysms.

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Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Cerebrovascular Disease

Background:

  • Complex aneurysms often necessitate parent vessel occlusion when direct clipping is not feasible.
  • Cerebral revascularization is a critical adjunct in managing these challenging cases.

Purpose of the Study:

  • To evaluate the safety and efficacy of cerebral revascularization in patients undergoing surgical arterial occlusion for complex aneurysms.
  • To compare the risks of revascularization with the cumulative risks of untreated aneurysms.

Main Methods:

  • A consecutive series of 61 patients with 63 complex aneurysms underwent revascularization procedures.
  • Various revascularization techniques were employed, including different types of bypass grafts and primary reanastomosis.
  • Aneurysms were located in diverse intracranial and extracranial segments of the internal carotid, middle cerebral, anterior cerebral, vertebral, and basilar arteries.

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Main Results:

  • Fifty-seven out of 61 patients (93%) achieved good clinical outcomes.
  • The overall surgical mortality rate was 2% (one patient death).
  • Revascularization procedures included petrous to supraclinoid ICA bypass, STA-MCA bypass, long saphenous bypass, in situ bypass, and primary reanastomosis.

Conclusions:

  • Cerebral revascularization can be performed with low morbidity and mortality in the context of complex aneurysm treatment.
  • The benefits of revascularization outweigh the surgical risks, especially when compared to the potential complications of untreated aneurysms following arterial occlusion.