The application of intracranial-intracranial bypass for the treatment of complex intracranial aneurysms
Objective To explore the efficacy and safety of intracranial-intracranial bypass for the treatment of complex intracranial aneurysms.Methods and Results A total of 32 patients with complex intracranial aneurysms who were hospitalized for treatment at Huashan Hospital,Fudan University from January 2015 to December 2023 were included.Surgical methods included in-situ bypass,reimplantation,reanastomosis and bypass with interposition graft.For middle cerebral artery(MCA)aneurysms(n=16),there were 5 cases of in-situ bypass,one case of reimplantation,3 cases of reanastomosis,and 7 cases of bypass with interposition graft.For anterior cerebral artery(ACA)aneurysms(n=8),there were 5 cases of in-situ bypass and 3 cases of reimplantation.For anterior communicating artery(ACoA)aneurysms(n=2),both cases were in-situ bypass.For posterior circulation aneurysms(n=6),there were 3 cases of in-situ bypass,2 cases of reanastomosis,and one case of bypass with interposition graft.The intraoperative graft vessels patency rate was 100%.Among the 23 patients who participated in follow-up imaging for more than 6 months postoperatively,no obvious recurrence was indicated by imaging.Among the 28 patients who participated in modified Rankin Scale(mRS)follow-up,there was one case of 5,5 cases of 3,2 cases of 2,one case of 1,and 19 cases of 0.Postoperative hemorrhagic complications occurred in 3 cases(9.37%),and ischemic complications occurred in 10 cases(31.25%),with no patients requiring unplanned secondary surgery for complication treatment.Conclusions Intracranial-intracranial bypass has good efficacy and safety for the treatment of complex intracranial aneurysms and has unique advantages in the microsurgical treatment of complex intracranial aneurysms.
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