大村 佳大
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Assistant Professor |
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Article types | Original article |
Language | English |
Peer review | Peer reviewed |
Title | High-flow bypass using saphenous vein grafts with trapping of ruptured blood blister-like aneurysms of the internal carotid artery: patient series. |
Journal | Formal name:Journal of neurosurgery. Case lessons Abbreviation:J Neurosurg Case Lessons ISSN code:26941902/26941902 |
Domestic / Foregin | Foregin |
Volume, Issue, Page | 2(18),pp.CASE21439 |
Author and coauthor | Ishiguro Taichi, Yamaguchi Koji, Ishikawa Tatsuya, Ottomo Daiki, Funatsu Takayuki, Matsuoka Go, Omura Yoshihiro, Kawamata Takakazu |
Publication date | 2021/11 |
Summary | BACKGROUND:Trapping an aneurysm after the establishment of an extracranial to intracranial high-flow bypass is considered the optimal surgical strategy for ruptured blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA). For high-flow bypass surgeries, a radial artery graft is generally preferred over a saphenous vein graft (SVG). However, SVGs can be advantageous in acute-phase surgeries because of their greater length, easy manipulability, ability to act as high-flow conduits, and reduced risk of vasospasms. In this study, the authors presented five cases of ruptured BBAs treated with high-flow bypass using an SVG followed by BBA trapping, and they reported on surgical outcomes and operative nuances that may help avoid potential pitfalls.OBSERVATIONS:After the surgeries, there were no ischemic or hemorrhagic complications, including symptomatic vasospasms. In three of the five cases, postoperative modified Rankin scale scores were between 0 and 2 at the 3-month follow-up. In one case, the SVG spontaneously occluded after surgery while the protective superficial temporal artery (STA) to middle cerebral artery (MCA) bypass became dominant, and the patient experienced no ischemic symptoms.LESSONS:High-flow bypass using an SVG with a protective STA-MCA bypass followed by BBA trapping is a safe and effective treatment strategy. |
DOI | 10.3171/CASE21439 |
PMID | 36061625 |