Treatment strategy for intracavernous aneurysms of internal carotid artery: report of 13 cases with extracranio-intracranial bypass

Abstract

Objective To analyze the indications and factors that influence the effectiveness of the treatment of intracavernous internal carotid aneurysms. Method From Oct. 2006 to Mar. 2010,13 cases of intracavemous internal carotid aneurysms were operated with EC - IC bypass, sacrifice of the internal carotid artery,and trapping of the aneurysms. The age of these patients was from 11 to 69 years old( median age 55). 12 patients were female. Only ones aneurysm was moderate,and the others were large or giant Results The bypass grafts were patent in 12 cases by post-operative DSA or CTA. One patient was reoperated but the bypass vessel was occluded finally. 8 cases had very good results without any neural deficit. 5 cases had severe complications such as hemiplegia,aphasia and coma. Of these 5 cases,2 recovered to GOS 4 finally, and 3 remained GOS 3. Thrombosis was found in all aneurysms in CT scan and disappearance of aneurysms was confirmed by CTA or DSA. Conclusions In conjunction with bypass surgery, IC A trapping constitutes an effective treatment strategy. With continued improvement of bypass techniques and perioperative care to decrease the occurrence of ischemic complications, the cure ratio will be elevated obviously in the future. Key words: Intracranial aneurysm; Internal carotid artery; Cavernous sinus; EC -IC bypass