Treatment of intracranial aneurysms by combined proximal ligation and extracranial-intracranial bypass with vein graft

Michael Morgan*, Michael Besser, Nicholas Dorsch, John Segelov

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Seven patients with internal carotid artery aneurysms, and one patient with a middle cerebral artery aneurysm, were managed by combining proximal ligation with an extracranial-intracranial bypass procedure. Five bypasses were done with an interposed vein graft between the external carotid artery and the distal middle cerebral artery (vein graft), and three were superficial temporal-middle cerebral artery bypasses (superficial temporal artery grafts). As demonstrated in postoperative angiograms, all eight patients had patent bypasses with nonfilling of the aneurysm. One patient developed transient dysphasia, but there were no permanent neurological deficits associated with carotid occlusion. Four patients had resolution of their neurological problems, and another three patients improved. The distribution of flow from vein grafts is more extensive than from superficial temporal artery grafts. This offers increased protection against ischemia, and increases the likelihood of internal carotid artery aneurysm thrombosis by reducing the turbulence in the distal internal carotid artery.

Original languageEnglish
Pages (from-to)85-91
Number of pages7
JournalSurgical Neurology
Volume26
Issue number1
DOIs
Publication statusPublished - 1986
Externally publishedYes

Keywords

  • Carotid ligation
  • Intracranial aneurysm
  • Superficial temporal artery-middle cerebral artery bypass
  • Vein graft

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