The application of intracranial-intracranial bypass for the treatment of complex basilar artery aneurysms
Objective To explore the surgical procedures and indications of intracranial-intracranial bypass for the treatment of complex aneurysms in the basilar artery(BA).Methods and Results A retrospective analysis was conducted on the clinical data and treatment process of 6 patients with complex BA aneurysms who underwent intracranial-intracranial bypass from April 2017 to April 2023 in Tianjin Huanhu Hospital.Among the 6 aneurysms,3 were vertebro basilar dolichoectasia aneurysms,one was an aneurysm in the upper segment of BA combined with severe stenosis at the proximal of the aneurysm,and 2 were giant dissecting aneurysms of the BA.Among them,5 were ruptured aneurysms,with one case of Hunt-Hess grade Ⅴ,one case of grade Ⅳ,2 cases of grade Ⅲ,and one case of grade Ⅱ,while the remaining one case was an unruptured aneurysm.One patient underwent petrous segment of internal carotid artery(ICA)-radial artery(RA)-posterior cerebral artery(PCA)bypass combined with aneurysm clipping,4 patients underwent V3 segment of vertebral artery(VA)-RA-PCA bypass combined with aneurysm trapping,and one patient underwent middle cerebral artery(MCA)-RA-PCA bypass combined with aneurysm trapping.Four patients had good prognosis,with modified Rankin Scale(mRS)0 to 3,one case scored 4 and one case died one week after surgery.Conclusions For complex aneurysms of the BA that cannot be treated with conventional methods,intracranial-intracranial bypass provides a good option.It is necessary to select the appropriate surgical procedure based on the actual situation in clinical practice.
万方数据
维普
