Complex Internal Carotid Aneurysms Treated by Superficial Temporal Artery Trunk–Radial Artery–Middle Cerebral Artery Bypass Combined with Balloon Occlusion of Internal Carotid Artery

Abstract

To evaluate the feasibility to treat complex internal carotid aneurysms by superficial temporal artery trunk-radial artery-middle cerebral artery (STAT-RA-MCA) bypass combined with balloon occlusion of internal carotid artery. Postoperative clinical symptoms, the patency of bridge vessels (radial artery graft [RAG]), STAT and RAG diameters, RAG flow, cerebral blood flow (CBF), and mean transit time (MTT) were observed in 14 cases. Their correlations were analyzed. Except 1 case, RAG was patent in 13 cases. Glasgow Outcome Scale score was 4 in one case and 5 in 13 cases. In the 13 cases with postoperative RAG patency, the mean diameter of STAT increased from 2.1 mm before operation to 3.0 mm on the first day after operation; the mean diameter of RAG was 3.7 mm on the first day after operation. In 3 of the 13 cases, STAT and RAG diameters further increased to 4.0 mm and 4.7 mm, respectively, 3 months after operation. There was a positive correlation between STAT and RAG diameters (P= 0.0005). The STAT (P< 0.0001, P < 0.0001) and RAG (P < 0.0001, P= 0.0042) diameters were positively correlated with RAG flow and CBF, but the STAT (r2= 0.762, P < 0.0001) and RAG (r2= 0.54, P= 0.0042) diameters were negatively correlated with MTT. STAT-RA-MCA bypass combined with balloon occlusion of internal carotid artery is feasible for the treatment of complex internal carotid aneurysms.