Extracranial-intracranial bypass for the treatment of cavernous sinus aneurysms.
The optimal management of symptomatic cavernous sinus aneurysms remains controversial. Carotid occlusion is a simple procedure, but carries an ongoing risk of early and late stroke. Cerebral revascularisation is technically demanding and carries a risk of morbidity and mortality of around 10%. Eight patients treated with an extracranial-intracranial vascular bypass graft over a period of 44 months for symptomatic cavernous sinus aneurysms are reviewed. At a mean follow-up of 20 months, seven patients (87.5%) had an excellent outcome (Glasgow Outcome Score 5) while one patient suffered a perioperative stroke. In only one case, where the radial artery had been used, the graft became occluded. The results of this series seem to indicate that cerebral revascularisation is an effective treatment for patients with symptomatic cavernous sinus aneurysms.
Chibbaro
S
S
Department of Neurosurgery, University Hospital Trieste, Strada di Fiume 447, 34100 Trieste, Italy.
Tacconi
L
L
D000328:Adult; D000368:Aged; D002342:Carotid Artery, External / Q000033:anatomy & histology / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D020215:Carotid Artery, Internal, Dissection / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002426:Cavernous Sinus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000379:methods* / Q000639:trends; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011182:Postoperative Care / Q000592:standards; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D017534:Radial Artery / Q000033:anatomy & histology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D012501:Saphenous Vein / Q000033:anatomy & histology / Q000601:surgery; D020521:Stroke / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D016378:Tissue Transplantation / Q000379:methods / Q000639:trends; D016896:Treatment Outcome