Revascularization with saphenous vein bypasses for complex intracranial aneurysms

Alfredo Quiñones-Hinojosa, Rose Du, Michael T. Lawton

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Most intracranial aneurysms can be managed with either microsurgical clipping or endovascular coiling. A subset of complex aneurysms with aberrant anatomy or fusiform/dolichoectatic morphology may require revascularization as part of a strategy that occludes the aneurysm or parent artery or both. Bypass techniques have been invented to revascularize nearly every intracranial artery. An aneurysm that will require a saphenous vein bypass is one that cannot be treated with conventional microsurgical clipping or endovascular coiling and also requires deliberate sacrifice of a major intracranial artery as part of the alternative treatment strategy. In the past 7 years the senior author (MTL) has performed a total of 110 bypasses, of which 46 were for aneurysms. Twenty-two of these patients received high-flow extracranial-to-intracranial bypasses using saphenous vein grafts, of which 16 had aneurysms that were giant in size. We review the indications for saphenous vein bypasses for complex intracranial aneurysms, surgical techniques, and clinical management strategies.

Original languageEnglish (US)
Pages (from-to)119-132
Number of pages14
JournalSkull Base
Volume15
Issue number2
DOIs
StatePublished - May 1 2005

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Keywords

  • Anastomosis
  • Intracranial aneurysm
  • Microsurgery
  • Revascularization
  • Saphenous vein graft
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology

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