Application of Surgical Revascularization Technique in Giant Aneurysm of the Extracranial Internal Carotid Artery: Technical Report

Overview

Journal Acta Neurochir (Wien)

Specialty Neurosurgery

Date 2024 Oct 15

PMID 39404897

Authors

Xingdong Wang

Meng Zhang

Xiaoguang Tong

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study is to illustrate the diagnostic and therapeutic value and clinical significance of surgical revascularization in giant aneurysms of the extracranial internal carotid artery.

Methods: The research team screened a group of cases of giant aneurysms of the extracranial internal carotid artery and analyzed the detailed information of the enrolled patients in terms of their basic clinical characteristics, surgical approaches and clinical prognosis.

Results: All patients had a good prognosis, except for one patient who was left with only mild facial nerve palsy (grade II facial paralysis). The results demonstrate that surgical revascularization is effective and safe in the treatment of giant aneurysms of the extracranial internal carotid artery.

Conclusion: The significant conclusion of this study is to provide an ideal alternative treatment for the treatment of giant aneurysms of the extracranial internal carotid artery. The surgical revascularization technique is a powerful tool for vascular neurosurgeons in the management of complex cerebrovascular diseases when traditional surgical clipping or endovascular interventions encounter bottlenecks.

References

Blanco E, Serrano F, Reina R, Martin A, Monux G, Ponce A . Saccular aneurysms of the extracranial internal carotid artery. Experience and review of the literature. J Cardiovasc Surg (Torino). 2008; 49(1):73-8. View

Chen D, Arriaga M, Fukushima T . Technical refinements in retraction for middle fossa surgery. Am J Otol. 1998; 19(2):208-11. View

Day J, Fukushima T, Giannotta S . Microanatomical study of the extradural middle fossa approach to the petroclival and posterior cavernous sinus region: description of the rhomboid construct. Neurosurgery. 1994; 34(6):1009-16; discussion 1016. DOI: 10.1227/00006123-199406000-00009. View

Frosen J, Tulamo R, Paetau A, Laaksamo E, Korja M, Laakso A . Saccular intracranial aneurysm: pathology and mechanisms. Acta Neuropathol. 2012; 123(6):773-86. DOI: 10.1007/s00401-011-0939-3. View

Hoh B, Ko N, Amin-Hanjani S, Chou S, Cruz-Flores S, Dangayach N . 2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage: A Guideline From the American Heart Association/American Stroke Association. Stroke. 2023; 54(7):e314-e370. DOI: 10.1161/STR.0000000000000436. View

Hosokawa K, Hata Y, Yano K, Matsuka K, Ito O, Ogli K . Results of the Allen test on 2,940 arms. Ann Plast Surg. 1990; 24(2):149-51. DOI: 10.1097/00000637-199002000-00007. View

Lawton M, Lang M . The future of open vascular neurosurgery: perspectives on cavernous malformations, AVMs, and bypasses for complex aneurysms. J Neurosurg. 2019; 130(5):1409-1425. DOI: 10.3171/2019.1.JNS182156. View

Lawton M, Spetzler R . Surgical strategies for giant intracranial aneurysms. Acta Neurochir Suppl. 1999; 72:141-56. DOI: 10.1007/978-3-7091-6377-1_12. View

Lawton M, Hamilton M, Morcos J, Spetzler R . Revascularization and aneurysm surgery: current techniques, indications, and outcome. Neurosurgery. 1996; 38(1):83-92; discussion 92-4. DOI: 10.1097/00006123-199601000-00020. View

10.

Liu J, Fukushima T, Sameshima T, Al-Mefty O, Couldwell W . Increasing exposure of the petrous internal carotid artery for revascularization using the transzygomatic extended middle fossa approach: a cadaveric morphometric study. Neurosurgery. 2006; 59(4 Suppl 2):ONS309-18. DOI: 10.1227/01.NEU.0000232638.96933.A0. View

11.

Mokri B, Piepgras D, Sundt Jr T, Pearson B . Extracranial internal carotid artery aneurysms. Mayo Clin Proc. 1982; 57(5):310-21. View

12.

Morton R, Moore A, Barber J, Tariq F, Hare K, Ghodke B . Monitoring flow in extracranial-intracranial bypass grafts using duplex ultrasonography: a single-center experience in 80 grafts over 8 years. Neurosurgery. 2013; 74(1):62-70. DOI: 10.1227/NEU.0000000000000198. View

13.

Noad R, ODonnell M, McCavert M, Gardner R, Lee B, Lau L . A carotid artery aneurysm with a twist: case report and review. Ir J Med Sci. 2009; 181(3):321-4. DOI: 10.1007/s11845-009-0353-1. View

14.

OConnell J, Darcy S, Reil T . Extracranial internal carotid artery mycotic aneurysm: case report and review. Vasc Endovascular Surg. 2009; 43(4):410-5. DOI: 10.1177/1538574409340590. View

15.

Oh H, Bae J, Hong C, Kim K, Yoo D, Kang H . Stent-Assisted Coil Embolization Versus Flow-Diverting Stent in Unruptured Vertebral Artery Dissecting Aneurysms: Efficacy and Safety Comparison. Neurosurgery. 2023; 93(1):120-127. DOI: 10.1227/neu.0000000000002384. View

16.

Ota N, Petrakakis I, Kondo T, Kinoshita Y, Noda K, Kamiyama H . Complex Bypass Surgery for Multiple Fusiform Aneurysms, Including a Thrombosed Giant Aneurysm of the Middle Cerebral Artery. World Neurosurg. 2020; 138:284. DOI: 10.1016/j.wneu.2020.03.026. View

17.

Ozaydin B, Baykal D, Ezgu M, Baskaya M . A Posterior Communicating Segment Aneurysm of the Supraclinoid Internal Carotid Artery Treated with an Extracranial to Intracranial Bypass and Trapping. J Neurol Surg B Skull Base. 2022; 83(Suppl 3):e616-e618. PMC: 9451953. DOI: 10.1055/s-0041-1725940. View

18.

Pinzon M, Lobelo N, Rodriguez M, Villamor P, Otoya A . Endovascular management of iatrogenic cervical internal carotid artery pseudoaneurysm in a 9-year-old child: Case report and literature review. Int J Pediatr Otorhinolaryngol. 2017; 95:29-33. DOI: 10.1016/j.ijporl.2017.01.031. View

19.

Reidy J, Faulder K, Davidson K, Harrington T, Steinfort B, Assaad N . Endovascular and microsurgical management of blister aneurysms: a multi-centre review. Neurosurg Rev. 2023; 46(1):147. DOI: 10.1007/s10143-023-02065-6. View

20.

Santoro A, Passacantilli E, Guidetti G, Dazzi M, Guglielmi G, Cantore G . Bypass combined with embolization via a venous graft in a patient with a giant aneurysm in the posterior communicating artery and bilateral idiopathic occlusion of the internal carotid artery in the neck. J Neurosurg. 2002; 96(1):135-9. DOI: 10.3171/jns.2002.96.1.0135. View