山口 浩司
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
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 / ForeginForegin
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
Authorship 2nd author,Corresponding author
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