TY - JOUR
T1 - Revascularization with saphenous vein bypasses for complex intracranial aneurysms
AU - Quiñones-Hinojosa, Alfredo
AU - Du, Rose
AU - Lawton, Michael T.
PY - 2005/5
Y1 - 2005/5
N2 - 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.
AB - 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.
KW - Anastomosis
KW - Intracranial aneurysm
KW - Microsurgery
KW - Revascularization
KW - Saphenous vein graft
KW - Subarachnoid hemorrhage
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U2 - 10.1055/s-2005-870598
DO - 10.1055/s-2005-870598
M3 - Article
C2 - 16148973
AN - SCOPUS:21044454744
VL - 15
SP - 119
EP - 132
JO - Journal of Neurological Surgery, Part B: Skull Base
JF - Journal of Neurological Surgery, Part B: Skull Base
SN - 2193-6331
IS - 2
ER -