Saphenous vein graft bypass in the treatment of giant cavernous sinus aneurysms: report of two cases

Arquivos de Neuro-Psiquiatria

Ricardo Ramina²  Murilo S. Meneses²  Ari A Pedrozo²  Walter O. Arruda²  Guilherme Borges¹ 

[1] ,Fundação Curitiba Pró-Base do Crânio Instituto de Neurologia de Curitiba Curitiba PR

关键词: giant intracavernous aneurysm;    internal carotid artery aneurysm;    saphenous vein graft;    cerebral revascularization;    aneurisma gigante intracavernoso;    aneurisma da artéria carótida interna;    enxerto venoso;    revascularização cerebral;   

DOI  :  10.1590/S0004-282X2000000100025

来源: SciELO

【 摘 要 】

Two cases of giant intracavernous aneurysms treated by high flow bypass with saphenous vein graft between the external carotid artery (ECA) and branches of the middle cerebral artery (MCA) are presented. Very often these aneurysms are unclippable because they are fusiform or have a large neck. Occlusion of the internal carotid artery (ICA) is the treatment of choice in many cases. This procedure has however a high risk of brain infarction. Revascularization of the brain by extra-intracranial anastomosis between the superficial temporal artery (STA) and branches of the MCA is frequently performed. This procedure provides however a low flow bypass and brain infarction may occur. We report two cases of giant cavernous sinus aneurysms treated by high flow bypass and endovascular balloon occlusion of the ICA. Immediate high flow revascularization of MCA branches was achieved and the patients showed no ischemic events. Follow-up of 8 and 14 months after operation shows patency of the venous graft and no neurological deficits. Angiographic control examination showed complete aneurysm occlusion in both cases.

【 授权许可】

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