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A Hybrid Strategy for Patients With Complex Cerebral Aneurysm: STA–MCA Bypass in Combination With Endovascular Embolization

Objective: This work aims to present our experience of patients with complex cerebral aneurysm treated with a hybrid approach: superficial temporal artery–middle cerebral artery (STA–MCA) bypass in combination with endovascular exclusion of the aneurysm. Method: Patients with aneurysms deemed unclip...

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Autores principales: Wang, Gang, Zhang, Xi'an, Gou, Yanxia, Wen, Yunyu, Zhang, Guozhong, Li, Mingzhou, Zhang, Shichao, Yin, Yanyi, Chen, Siyuan, Qi, Songtao, Feng, Wenfeng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844085/
https://www.ncbi.nlm.nih.gov/pubmed/33519692
http://dx.doi.org/10.3389/fneur.2020.614601
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author Wang, Gang
Zhang, Xi'an
Gou, Yanxia
Wen, Yunyu
Zhang, Guozhong
Li, Mingzhou
Zhang, Shichao
Yin, Yanyi
Chen, Siyuan
Qi, Songtao
Feng, Wenfeng
author_facet Wang, Gang
Zhang, Xi'an
Gou, Yanxia
Wen, Yunyu
Zhang, Guozhong
Li, Mingzhou
Zhang, Shichao
Yin, Yanyi
Chen, Siyuan
Qi, Songtao
Feng, Wenfeng
author_sort Wang, Gang
collection PubMed
description Objective: This work aims to present our experience of patients with complex cerebral aneurysm treated with a hybrid approach: superficial temporal artery–middle cerebral artery (STA–MCA) bypass in combination with endovascular exclusion of the aneurysm. Method: Patients with aneurysms deemed unclippable and uncoilable were included. All patients were treated with a hybrid approach. After STA–MCA bypass, the parent artery was temporarily occluded. If the intraoperative motor evoked potential (MEP) and somatosensory evoked potential (SEP) waveforms remain normal and last for 30 min, the aneurysm and te parent artery will be embolized permanently with detachable balloons or coils. Results: A total of 20 patients with 22 aneurysms were included in this study. There were 13 women and 7 men, with an average age of 42.5 years. Intraoperative angiography showed the good patency of all the STA grafts, and neither SEP nor MEP abnormalities were detected. After the parent artery and the aneurysm were occluded, the intraoperative angiography showed an immediately successful exclusion of the aneurysm in 20 aneurysms and immediate contrast stasis in two. All patients recovered uneventfully without ischemic or hemorrhagic complication. Angiography at 6-month follow-up showed the total obliteration in 20 aneurysms. Two aneurysms showed residuals and were recoiled. All STA grafts showed a good patency, and the mean graft flow was 124.2 ml/min. Conclusion: STA–MCA bypass in combination with endovascular exclusion is an appropriate option for patients with complex cerebral aneurysms that are not amenable to direct surgical clipping or endovascular embolization.
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spelling pubmed-78440852021-01-30 A Hybrid Strategy for Patients With Complex Cerebral Aneurysm: STA–MCA Bypass in Combination With Endovascular Embolization Wang, Gang Zhang, Xi'an Gou, Yanxia Wen, Yunyu Zhang, Guozhong Li, Mingzhou Zhang, Shichao Yin, Yanyi Chen, Siyuan Qi, Songtao Feng, Wenfeng Front Neurol Neurology Objective: This work aims to present our experience of patients with complex cerebral aneurysm treated with a hybrid approach: superficial temporal artery–middle cerebral artery (STA–MCA) bypass in combination with endovascular exclusion of the aneurysm. Method: Patients with aneurysms deemed unclippable and uncoilable were included. All patients were treated with a hybrid approach. After STA–MCA bypass, the parent artery was temporarily occluded. If the intraoperative motor evoked potential (MEP) and somatosensory evoked potential (SEP) waveforms remain normal and last for 30 min, the aneurysm and te parent artery will be embolized permanently with detachable balloons or coils. Results: A total of 20 patients with 22 aneurysms were included in this study. There were 13 women and 7 men, with an average age of 42.5 years. Intraoperative angiography showed the good patency of all the STA grafts, and neither SEP nor MEP abnormalities were detected. After the parent artery and the aneurysm were occluded, the intraoperative angiography showed an immediately successful exclusion of the aneurysm in 20 aneurysms and immediate contrast stasis in two. All patients recovered uneventfully without ischemic or hemorrhagic complication. Angiography at 6-month follow-up showed the total obliteration in 20 aneurysms. Two aneurysms showed residuals and were recoiled. All STA grafts showed a good patency, and the mean graft flow was 124.2 ml/min. Conclusion: STA–MCA bypass in combination with endovascular exclusion is an appropriate option for patients with complex cerebral aneurysms that are not amenable to direct surgical clipping or endovascular embolization. Frontiers Media S.A. 2021-01-15 /pmc/articles/PMC7844085/ /pubmed/33519692 http://dx.doi.org/10.3389/fneur.2020.614601 Text en Copyright © 2021 Wang, Zhang, Gou, Wen, Zhang, Li, Zhang, Yin, Chen, Qi and Feng. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Wang, Gang
Zhang, Xi'an
Gou, Yanxia
Wen, Yunyu
Zhang, Guozhong
Li, Mingzhou
Zhang, Shichao
Yin, Yanyi
Chen, Siyuan
Qi, Songtao
Feng, Wenfeng
A Hybrid Strategy for Patients With Complex Cerebral Aneurysm: STA–MCA Bypass in Combination With Endovascular Embolization
title A Hybrid Strategy for Patients With Complex Cerebral Aneurysm: STA–MCA Bypass in Combination With Endovascular Embolization
title_full A Hybrid Strategy for Patients With Complex Cerebral Aneurysm: STA–MCA Bypass in Combination With Endovascular Embolization
title_fullStr A Hybrid Strategy for Patients With Complex Cerebral Aneurysm: STA–MCA Bypass in Combination With Endovascular Embolization
title_full_unstemmed A Hybrid Strategy for Patients With Complex Cerebral Aneurysm: STA–MCA Bypass in Combination With Endovascular Embolization
title_short A Hybrid Strategy for Patients With Complex Cerebral Aneurysm: STA–MCA Bypass in Combination With Endovascular Embolization
title_sort hybrid strategy for patients with complex cerebral aneurysm: sta–mca bypass in combination with endovascular embolization
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844085/
https://www.ncbi.nlm.nih.gov/pubmed/33519692
http://dx.doi.org/10.3389/fneur.2020.614601
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