Superficial temporal artery-middle cerebral artery bypass for the treatment of complex middle cerebral artery aneurysms

Objectives: Direct microsurgical clipping for complex middle cerebral artery (MCA) aneurysms may require a long ischemic time. Sacrifice of the parent artery with trapping or endovascular coiling also may lead to ischemic stroke. We described our institutional experience with the treatment of comple...

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Main Authors: Chien-Hui Lee, Sheng-Tzung Tsai, Tsung-Lang Chiu
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2018-01-01
Series:Tzu Chi Medical Journal
Subjects:
Online Access:http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2018;volume=30;issue=2;spage=110;epage=115;aulast=Lee
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author Chien-Hui Lee
Sheng-Tzung Tsai
Tsung-Lang Chiu
author_facet Chien-Hui Lee
Sheng-Tzung Tsai
Tsung-Lang Chiu
author_sort Chien-Hui Lee
collection DOAJ
description Objectives: Direct microsurgical clipping for complex middle cerebral artery (MCA) aneurysms may require a long ischemic time. Sacrifice of the parent artery with trapping or endovascular coiling also may lead to ischemic stroke. We described our institutional experience with the treatment of complex MCA aneurysms using extracranial-intracranial (EC-IC) (superficial temporal artery [STA]-MCA) bypass. Materials and Methods: We retrospectively reviewed patients who had treatment of IC aneurysms with the assistance of STA-MCA bypass from July 2002 to December 2016. Six patients with complex MCA aneurysms were identified, and we reviewed their clinical characteristics. Results: There were three men and three women with age ranging from 27 to 59 (mean 49) years old. Image studies showed subarachnoid hemorrhage in three cases. All patients underwent STA-MCA anastomosis, and the follow-up period ranged from 2 to 116 months (mean 51.5 months). Two of the six MCA aneurysms were fusiform, two aneurysms had bizarre configurations, one was a dissecting saccular aneurysm, and one had a blister configuration. Three patients received direct vessel trapping, two patients received aneurysm clipping, and one received aneurysm coiling. The postoperative bypass patency rate was 100%. The modified Rankin scale showed good outcomes in the six patients. Conclusions: EC-IC bypass plays an important role as a salvage procedure in the treatment of complex MCA aneurysms which have a fusiform, bizarre, or blister configuration.
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spelling doaj-art-307d97cd251a4f8da3a9186c91333ead2025-08-20T01:48:41ZengWolters Kluwer Medknow PublicationsTzu Chi Medical Journal1016-31902223-89562018-01-0130211011510.4103/tcmj.tcmj_193_17Superficial temporal artery-middle cerebral artery bypass for the treatment of complex middle cerebral artery aneurysmsChien-Hui LeeSheng-Tzung TsaiTsung-Lang ChiuObjectives: Direct microsurgical clipping for complex middle cerebral artery (MCA) aneurysms may require a long ischemic time. Sacrifice of the parent artery with trapping or endovascular coiling also may lead to ischemic stroke. We described our institutional experience with the treatment of complex MCA aneurysms using extracranial-intracranial (EC-IC) (superficial temporal artery [STA]-MCA) bypass. Materials and Methods: We retrospectively reviewed patients who had treatment of IC aneurysms with the assistance of STA-MCA bypass from July 2002 to December 2016. Six patients with complex MCA aneurysms were identified, and we reviewed their clinical characteristics. Results: There were three men and three women with age ranging from 27 to 59 (mean 49) years old. Image studies showed subarachnoid hemorrhage in three cases. All patients underwent STA-MCA anastomosis, and the follow-up period ranged from 2 to 116 months (mean 51.5 months). Two of the six MCA aneurysms were fusiform, two aneurysms had bizarre configurations, one was a dissecting saccular aneurysm, and one had a blister configuration. Three patients received direct vessel trapping, two patients received aneurysm clipping, and one received aneurysm coiling. The postoperative bypass patency rate was 100%. The modified Rankin scale showed good outcomes in the six patients. Conclusions: EC-IC bypass plays an important role as a salvage procedure in the treatment of complex MCA aneurysms which have a fusiform, bizarre, or blister configuration.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2018;volume=30;issue=2;spage=110;epage=115;aulast=LeeAneurysmBypassExtracranial-intracranialMiddle cerebral arterySuperficial temporal artery-middle cerebral artery
spellingShingle Chien-Hui Lee
Sheng-Tzung Tsai
Tsung-Lang Chiu
Superficial temporal artery-middle cerebral artery bypass for the treatment of complex middle cerebral artery aneurysms
Tzu Chi Medical Journal
Aneurysm
Bypass
Extracranial-intracranial
Middle cerebral artery
Superficial temporal artery-middle cerebral artery
title Superficial temporal artery-middle cerebral artery bypass for the treatment of complex middle cerebral artery aneurysms
title_full Superficial temporal artery-middle cerebral artery bypass for the treatment of complex middle cerebral artery aneurysms
title_fullStr Superficial temporal artery-middle cerebral artery bypass for the treatment of complex middle cerebral artery aneurysms
title_full_unstemmed Superficial temporal artery-middle cerebral artery bypass for the treatment of complex middle cerebral artery aneurysms
title_short Superficial temporal artery-middle cerebral artery bypass for the treatment of complex middle cerebral artery aneurysms
title_sort superficial temporal artery middle cerebral artery bypass for the treatment of complex middle cerebral artery aneurysms
topic Aneurysm
Bypass
Extracranial-intracranial
Middle cerebral artery
Superficial temporal artery-middle cerebral artery
url http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2018;volume=30;issue=2;spage=110;epage=115;aulast=Lee
work_keys_str_mv AT chienhuilee superficialtemporalarterymiddlecerebralarterybypassforthetreatmentofcomplexmiddlecerebralarteryaneurysms
AT shengtzungtsai superficialtemporalarterymiddlecerebralarterybypassforthetreatmentofcomplexmiddlecerebralarteryaneurysms
AT tsunglangchiu superficialtemporalarterymiddlecerebralarterybypassforthetreatmentofcomplexmiddlecerebralarteryaneurysms