title: [Cerebral revascularization in treatment of intractable aneurysms].
abstract: OBJECTIVE
  To evaluate the effectiveness of cerebral revascularization in the treatment of intractable aneurysms and to discuss the indications, surgical techniques, and the outcome of the revascularization.
  
  
  METHODS
  During the recent 4-year period, 9 radical artery grafts were performed in patients with intractable or giant internal carotid artery (ICA) aneurysms. The indications for cerebral revascularization included parent vessel occlusion during the treatment of the intractable aneurysms with poor collateral circulation or the young patients. Modified techniques were taken to use the main trunk of superficial temporal artery (STA) as donor, while M3 branches near the bifurcation of the M2 segment of the middle cerebral artery (MCA) were chosen as the recipient arteries. STA-Radial artery (RA)-MCA bypass was followed by parent vessel occlusion via chronic cervical ICA ligation or balloon occlusion.
  
  
  RESULTS
  Postoperative angiography demonstrated the patency of the grafts in eight cases. The procedure of the parent vessels occlusion was uneventful in these patients. Follow-up showed the patients were in excellent conditions after successful treatment of aneurysms. Significantly delayed filling of the graft was revealed in one patient, who could not tolerate balloon occlusion test and occlusion of parent artery failed.
  
  
  CONCLUSIONS
  Extracranial-to-intracranial bypass followed by parent vessel occlusion is a safe and effective method to treat intractable ICA aneurysms. Radical artery as graft can offer high-flow revascularization with less complications. Combined surgical and endovascular treatment might be the future direction for the treatment of the difficult aneurysms.
authors.affiliation: Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China. yingmaoc@online.sh.cn
authors.forename: Ying
authors.initials: Y
authors.lastname: Mao
authors.forename: Liang-fu
authors.initials: LF
authors.lastname: Zhou
authors.forename: Dong-lei
authors.initials: DL
authors.lastname: Song
authors.forename: Bing
authors.initials: B
authors.lastname: Leng
authors.forename: Yu-xiang
authors.initials: YX
authors.lastname: Gu
authors.forename: Wei
authors.initials: W
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D002343:Carotid Artery, Internal / Q000601:surgery*; D002536:Cerebral Arteries / Q000601:surgery; D002548:Cerebral Revascularization / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000601:surgery*; D008026:Ligation; D008297:Male; D008875:Middle Aged