Skull Base 2005; 15(2): 119-132
DOI: 10.1055/s-2005-870598
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Revascularization with Saphenous Vein Bypasses for Complex Intracranial Aneurysms

Alfredo Quiñones-Hinojosa1 , Rose Du1 , Michael T. Lawton1
  • 1Department of Neurological Surgery, Center for Stroke and Cerebrovascular Disease, University of California, San Francisco, San Francisco, California
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Publikationsdatum:
02. Juni 2005 (online)

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ABSTRACT

Most intracranial aneurysms can be managed with either microsurgical clipping or endovascular coiling. A subset of complex aneurysms with aberrant anatomy or fusiform/dolichoectatic morphology may require revascularization as part of a strategy that occludes the aneurysm or parent artery or both. Bypass techniques have been invented to revascularize nearly every intracranial artery. An aneurysm that will require a saphenous vein bypass is one that cannot be treated with conventional microsurgical clipping or endovascular coiling and also requires deliberate sacrifice of a major intracranial artery as part of the alternative treatment strategy. In the past 7 years the senior author (MTL) has performed a total of 110 bypasses, of which 46 were for aneurysms. Twenty-two of these patients received high-flow extracranial-to-intracranial bypasses using saphenous vein grafts, of which 16 had aneurysms that were giant in size. We review the indications for saphenous vein bypasses for complex intracranial aneurysms, surgical techniques, and clinical management strategies.

REFERENCES

Michael T LawtonM.D. 

Department of Neurological Surgery, University of California, San Francisco

505 Parnassus Ave., Moffitt Hospital Rm. M779

Box 0112, San Francisco, CA 94143-0112

eMail: lawtonm@neurosurg.ucsf.edu