Curative effect of middle and high flow intracranial -external vascular bypass on complex intracranial aneurysms and selection of grafts
10.3760/cma.j.issn.1671-8925.2019.02.006
- VernacularTitle:中高流量颅内-外血管搭桥术治疗复杂性颅内动脉瘤的疗效及桥血管的选择研究
- Author:
Jinhu LIN
1
;
Junyu WANG
;
Fenghua CHEN
;
Yunhong TANG
;
Yuanbing CHEN
;
Jian LI
;
Jun HUANG
Author Information
1. 中南大学湘雅医院神经外科
- Keywords:
Extracranial-intracranial bypass;
Intracranial aneurysm;
Mid-high flow;
Graft
- From:
Chinese Journal of Neuromedicine
2019;18(2):144-149
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of middle and high (mid-high) flow intracranial-external vascular bypass in treatment of complex intracranial aneurysms and selection of grafts. Methods The clinical data of 79 patients with complicated intracranial aneurysms treated by mid-high flow extracranial-intracranial bypass in our hospital from August 2010 to October 2017 were collected retrospectively. The grafts were radial artery (n=21), saphenous vein of the calf segment (n=29) or thigh saphenous vein segment (n=29). The efficacy was determined based on Glasgow outcome scale (GOS) scores at discharge and modified Rankin scale (mRS) scores at follow-up, and the differences of occlusion in different types of grafts were analyzed. Results CTA showed patency of the grafts in all patients one d after surgery. There were 6 patients having vascular occlusion: 2 patients (the grafts at saphenous vein of the calf segment ) were occluded 3 and 4 d after surgery, without symptom; 2 patients (the grafts at the radial artery), with decreased limb muscle strength, were occluded 5 and 25 d after procedure; 2 patients ( the grafts at the saphenous veins of the calf segment) were occluded 6 months after procedure without any symptom. There were 4 patients developed cerebral ischemia after operation: one had cerebral infarction and three had vasospasm. GOS scores at discharge and mRS scores at follow-up showed that 78 patients had improved symptoms and good prognosis; one patient showed no improvement in symptoms and plant survival. Conclusion Mid-high flow extracranial-intracranial bypass for treatment of complex intracranial aneurysms is effective; the graft should be individually selected based on preoperative assessment results.
