title: [Extracranial-intracranial revascularization techniques in the treatment of complex aneurysms and prevention and management of occlusion of bypass vessels].
abstract: OBJECTIVE
  To study the revascularization techniques in the treatment of intracranial complex aneurysms and occlusive reasons of bypass vessel.
  
  
  METHODS
  The 20 complex intracranial aneurysms who underwent saphenous bypass treatment from November 2006 to November 2008 were retrospectively analyzed and the occlusive reasons were studied. Of the 20 patients, 12 were female and 8 were male, mean age was 54.5 years (ranged 27 - 65 years). The distribution of the lesions included 13 cavernous sinus aneurysms, 4 para-clinoid aneurysms, 2 supraclinoid aneurysms, and 1 basilar trunk aneurysm. Four aneurysms were giant (diameter > 25 mm), 12 aneurysms were large (15 - 25 mm), and 4 aneurysms were medium (10 - 15 mm) size.
  
  
  RESULTS
  One saphenous vein was occluded intraoperatively and one saphenous vein was occluded postoperatively. At discharge, 18 out of the 20 patients had Glasgow Outcome Scale (GOS) score of 4 or 5, 2 patients had score of 3, and 1 patient had score of 1. At 6 months follow up, 18 of 19 survivors had GOS score of 4 or 5 and 1 patient had score of 3.
  
  
  CONCLUSIONS
  Extracranial-intracranial revascularization technique is a safe and effective method in the treatment of complex aneurysms. Mechanical and hemodynamic factors are two leading reasons for occlusion of bypass vessels. Long-term bypass vessels patent rate still needs further observation.
authors.affiliation: Department of Neurosurgery, General Hospital of People's Liberation Army, Beijing 100853, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wu
authors.forename: Bai-Nan
authors.initials: BN
authors.lastname: Xu
authors.forename: Zheng-Hui
authors.initials: ZH
authors.lastname: Sun
authors.forename: Jin-Li
authors.initials: JL
authors.lastname: Jiang
authors.forename: Xin-Guang
authors.initials: XG
authors.lastname: Yu
authors.forename: Ding-Biao
authors.initials: DB
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D002548:Cerebral Revascularization / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000601:surgery; D016896:Treatment Outcome