Lf. Zhou et Dj. Jiang, CEREBRAL-ARTERY RECONSTRUCTION IN THE TREATMENT OF LARGE AND GIANT INTRACRANIAL ANEURYSMS, Chinese medical journal, 107(1), 1994, pp. 41-46
From 1978 to 1988, 14 giant intracranial aneurysms (more than 2.4 cm i
n diameter) and one large aneurysm (1.5 cm in diameter) were treated b
y extracranial / intracranial (EC / IC) bypass or cerebral artery reco
nstruction. Of the aneurysms, 10 were located at the intracavernous ca
rotid artery (CCA). One of the 10 anourysms was posttraumatic and loca
ted at both the carotid-ophthalmic artery segment and the bifurcation
of the internal carotid artery (ICA). Three were seen st the middle ce
rebral artery (MCA) trunk. The aneurysms were demonstrated by angiogra
phy and CT scanning. They were treated with trapping of the aneurysm a
nd superficial temporal artery (STA) / middle cerebral artery (STA-MCA
) bypass with / without a graft (6 cases), cervical ICA ligation and S
TA-MCA bypass with / without a graft (6) aneurysm excision with an end
-to-end anastomosis of the MCA and a STA-MCA bypass with a graft (1),
proximal MCA occlusion and STA-MCA bypass with a graft (1), and aneury
sm neck clipping following a STA-MCA bypass with a graft (1). The pati
ents showed marked improvement after operation except one whose neurol
ogical deficit was aggravated temporarily. Postoperative angiography r
evealed that the anastomoses were patent in all cases. No surgical mor
tality or any delayed ischemic complications were noted after follow-u
p for 5.6 years. We believe that cerebral artery reconstruction or EC
/ IC bypass is still effective in the treatment of large and giant int
racranial aneurysms.