Revascularization techniques in surgical treatment of large and giant anterior cerebral artery aneurysms: literature review

Abstract

Despite common use of revascularization for aneurysms of other locations, the role of bypass has been ignored for long time. In this study we describe actual status of revascularization in surgical treatment of ACA aneurysms based on an analysis of current literature. Search of literature was performed in data bases PubMed and Web of Science. Treatment of 80 patients in 24 articles was evaluated. In situ A3‑A3 bypass and extra — intracranial bypass with the superficial temporal artery are the most used techniques. The contralateral superficial temporal artery is the most convenient interposition graft for bypasses performed in patients with ACA aneurysms. There are no significant differences between extra-intracranial and intra-intracranial bypasses in terms of bypass patency and ischemic complications. The choice between different bypass techniques is based on an individual patient anatomy and surgeon preference.