Efficacy of extracranial-intracranial arterial bypass surgery for giant anterior circulation aneurysms

Abstract

Objective To investigate the surgical methods and efficacy of extracranial-intracranial (EC-IC) arterial bypass surgery for the treatment of giant anterior circulation aneurysms. Methods The clinical data of 11 patients with giant anterior circulation aneurysm treated with EC-IC artery bypass surgery at Sichuan Province People's Hospital from March 2010 to June 2014 were analyzed retrospectively. The vascular patency assessment was conducted by CT angiography and digital subtraction angiography (DSA). The selection of graft vessels, surgical methods, and clinical effect were investigated. Results Seven patients used external carotid artery-great saphenous vein-middle cerebral artery M2 segment bypass, 2 used external carotid artery-radial artery-middle cerebral artery M2 segment bypass, and 2 used superficial temporal artery-middle cerebral artery M4 segment bypass. The grafted vessels were patent in 9 cases after procedure; the grafted vessels were occluded in 2 cases, and the proportion of vascular patency was 9: 11. One patient performed emergency superficial temporal artery-middle cerebral artery bypass, his blood vessel was occluded at day 3 after procedure. His contralateral limb was paralyzed after surgery and his muscle strength? was grade Ⅲ. One patient had vascular occlusion? at 6 months after surgery,? and he did not have any symptoms of nerve? function? defect. The follow-up period ranged from 6 months to 51 months (mean 18.3 months). The Glasgow outcome scale scores at 6 months after surgery: 10 patients were good (4-5), 1 was poor (3), and no patients died. Conclusions EC-IC arterial bypass surgery is a safe and effective method for the treatment of giant anterior circulation aneurysms. The detailed and individualized treatment scheme may improve the surgical results. Key words: Intracranial aneurysm; Cerebral revascularization; Anterior circulation