Simplified Azygos Anterior Cerebral Bypass: Y-Shaped Superficial Temporal Artery Interposition Graft From A2 With Double Reimplantation of Pericallosal Arteries: Technical Case Report

被引：16

作者：

Mura, Jorge ^{[1
,2
]}

Riquelme, Francisco ^{[1
]}

Luis Cuevas, Jose ^{[1
,2
]}

Luna, Felipe ^{[1
,2
,3
]}

Vizhnay, Pablo ^{[1
,2
]}

机构：

[1] Inst Neurosurg Asenjo, Cerebrovasc & Skull Base Surg Team, Santiago, Chile

[2] Univ Chile, Dept Neurol Sci, Santiago, Chile

[3] Univ Valparaiso, Fac Med, Dept Biomed Sci, Valparaiso, Chile

来源：

NEUROSURGERY | 2013年 / 72卷 / 06期

关键词：

Anastomosis; Cerebral revascularization; Emergency bypass; Meningioma; Simplified azygos anterior cerebral artery bypass; Superficial temporal artery;

D O I：

10.1227/NEU.0b013e31827bc7c1

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

BACKGROUND AND IMPORTANCE: Trapping with distal revascularization is a therapeutic option for giant aneurysms that cannot be clipped or coiled. In skull base lesions such as meningiomas, arterial encasement is often present, requiring, in some cases, revascularization procedures: extracranial-to-intracranial bypass and more recently intracranial-to-intracranial techniques. These techniques are used only in exceptional cases of tumors in other localizations. CLINICAL PRESENTATION: We report a case of a recurrent malignant frontal falx meningioma with encasement of both pericallosal arteries (PcaAs). During resection of the lesion, the left PcaA was sectioned and the right PcaA was occluded for manipulation and coagulation of the tumor. The occlusion was diagnosed with indocyanine green videoangiography. A Y-shaped superficial temporal artery graft was obtained in the right side, and the anterior cerebral artery circulation was reconstructed using an intracranial-to-intracranial bypass in the following fashion: right A2 to superficial temporal artery Y-shaped graft for both PcaAs. The patient's postoperative period was uneventful with no deficit, and the angiographic computed tomography showed the preservation of both PcaAs. CONCLUSION: To the best of our knowledge, this nnicrosurgical reconstruction of the PcaAs has not been performed before in a meningioma or a complex aneurysm case. We think the use of a superficial temporal artery as an in situ graft is more straightforward compared with other interposition grafts such as the radial artery graft or saphenous vein graft. The use of intracranial-to-intracranial techniques is the proper evolution of the use of classic extracranial-to-intracranial cerebral revascularization techniques.

引用

页码：235 / 235

页数：1

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