High-flow bypass with radial artery graft for cavernous carotid aneurysm

Kumar, Amit; Sharma, Raghavendra Kumar; Tanaka, Riki; Yamada, Yashuhiro; Takizawa, Kazuyasu; Kato, Yōkō

doi:10.4103/ajns.ajns_82_20

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…1-6 Bypass techniques remain relevant in the cerebrovascular neurosurgeon's armamentarium for the treatment of complex ruptured and unruptured aneurysms that may not be amenable to or have failed endovascular treatment. 7-29 When a high-flow bypass is required for this purpose, radial artery grafts are especially effective. 30-38 We present a case of a 57-year-old woman who presented with acute left-sided hemiparesis after redo coiling of a recurrent giant right internal carotid artery terminus aneurysm that had previously undergone Atlas stent-assisted coiling.…”

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confidence: 99%

Common Carotid Artery to Middle Cerebral Artery Bypass With Radial Interposition Graft for Internal Carotid Artery (ICA) Occlusion After Stent-Coil Embolization of Giant ICA Terminus Aneurysm: 2-Dimensional Operative Video

Nguyen

Parikh

Motiwala

et al. 2022

Operative Neurosurgery

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Thrombosis and occlusion after stent-assisted coiling of aneurysms are well-known occurrences, with an incidence ranging from 5% to 20%. [1][2][3][4][5][6] Bypass techniques remain relevant in the cerebrovascular neurosurgeon's armamentarium for the treatment of complex ruptured and unruptured aneurysms that may not be amenable to or have failed endovascular treatment. When a high-flow bypass is required for this purpose, radial artery grafts are especially effective. [30][31][32][33][34][35][36][37][38] We present a case of a 57-year-old woman who presented with acute left-sided hemiparesis after redo coiling of a recurrent giant right internal carotid artery terminus aneurysm that had previously undergone Atlas stentassisted coiling. She underwent mechanical thrombectomy with TICI2b revascularization, but despite this intervention, she progressed to complete hemiplegia the following morning. Therefore, the patient underwent radial artery harvesting, cervical carotid neck exposure, and a pterional craniotomy. A common carotid-M2 direct bypass was performed using a radial artery interposition graft with complete flow restoration to the entire middle cerebral artery distribution. This surgical video reviews the case presentation, surgical anatomy, operative technique, and postoperative course and outcome. The patient gave verbal consent for participation in the procedure and surgical video.

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confidence: 99%

Common Carotid Artery to Middle Cerebral Artery Bypass With Radial Interposition Graft for Internal Carotid Artery (ICA) Occlusion After Stent-Coil Embolization of Giant ICA Terminus Aneurysm: 2-Dimensional Operative Video

Nguyen

Parikh

Motiwala

et al. 2022

Operative Neurosurgery

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Extra-intracranial bypass surgery using the orifice of maxillary artery in a patient with middle cerebral artery aneurysm. Case report and literature review

Lukyanchikov¹,

Shatokhin²,

Gorozhanin³

et al. 2022

Vopr. neirokhir.

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Combined microsurgical and endovascular approach in the hybrid operating angiosuite: A case series on blood-blister intracranial aneurysms

Ahn,

Choi,

Kim

et al. 2024

Preprint

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Purpose: Blood blister-like aneurysms (BBAs) are small, fragile vascular lesions that develop on the walls of the supraclinoid internal carotid artery. This absence of a neck complicates surgical and endovascular treatment options. The hybrid operating angiosuite (HOA), which integrates traditional surgical techniques with endovascular interventions, provides an innovative approach to managing BBAs. This study aims to evaluate a series of clinical cases focused on treating BBAs using a combination of microsurgical extracranial-intracranial bypass and endovascular trapping within the HOA. Methods:We analyzed a series of patients with BBAs treated from 2014 to 2022. Skilled bimanual neurovascular surgeons implemented treatment plans using both microsurgical and neurointerventional techniques across four distinguished neurosurgery centers: Kangdong Sacred Heart Hospital, Seoul St. Mary’s Hospital, Yongin Severance Hospital, and International St. Mary’s Hospital. Clinical outcomes were measured using the Glasgow Outcome Scale (GOS) at discharge and the modified Rankin Score (mRS) during follow-up, with scores of 0–2 indicating favorable outcomes. Follow-up imaging via computed tomography angiography or magnetic resonance angiography was conducted on average 6–12 months post-procedure to assess BBA recurrence and graft vessel patency. Results: Seven patients (average age, 45 years) were treated at the HOA. The surgical approach included high-flow bypass in five patients and superficial temporal artery double-barrel bypass in two. Follow-up imaging revealed no BBA recurrences and maintained patency of bypass flow. Conclusion: Our findings suggest that a hybrid approach offers a safer and more effective strategy for managing BBAs, potentially improving patient outcomes.

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High-flow bypass with radial artery graft for cavernous carotid aneurysm

Cited by 3 publications

References 28 publications

Common Carotid Artery to Middle Cerebral Artery Bypass With Radial Interposition Graft for Internal Carotid Artery (ICA) Occlusion After Stent-Coil Embolization of Giant ICA Terminus Aneurysm: 2-Dimensional Operative Video

Common Carotid Artery to Middle Cerebral Artery Bypass With Radial Interposition Graft for Internal Carotid Artery (ICA) Occlusion After Stent-Coil Embolization of Giant ICA Terminus Aneurysm: 2-Dimensional Operative Video

Extra-intracranial bypass surgery using the orifice of maxillary artery in a patient with middle cerebral artery aneurysm. Case report and literature review

Combined microsurgical and endovascular approach in the hybrid operating angiosuite: A case series on blood-blister intracranial aneurysms

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