脳動脈瘤手術における血行再建術の応用 : 適応と治療成績について(V5-5)  [in Japanese] Application of Revasculization Technique in Aneurysm Surgery : Kyorin University Experience  [in Japanese]

Between February 2004 and September 2005, revasculization technique was used in 10 patients with intracranial aneurysm to obliterate the aneurysm and to prevent ischemic complications. Five high-flow external carotid-internal carotid (EC-IC) bypasses with radial artery graft (EC-RA-M2) followed by proximal IC occlusion/trapping were used to obliterate unruptured IC-cavernous large/giant aneurysms and ruptured IC anterior wall aneurysms. One patient with ruptured VA-union dissecting aneurysm was successfully treated with vertebral-posterior cerebral artery high-flow bypass (V3-RA-P2) in combination with bilateral VA proximal occlusion. Three ruptured middle cerebral artery (MCA) and 1 distal anterior cerebral artery (ACA) aneurysms were obliterated in association with M2-RA-M2, STA-M2, A3-A3 bypasses preserving the parent artery. Postoperatively, no ischemic or hemorrhagic complications was observed, and all bypasses have remained patent with a mean follow-up period of 3.5 years. Adequate vascular reconstruction is effective in the treatment of complex aneurysms.