title: The efficacy of bypass surgery using a short interposition graft for the treatment of intracranial complex aneurysm.
abstract: OBJECTIVE
  To evaluate the efficacy of a short interposition graft using saphenous vein or radial artery to connect the proximal superficial temporal artery and the M2 segments of the middle cerebral artery for the treatment of complex intracranial aneurysm.
  
  
  METHODS
  From March 2007 to February 2012, short interposition graft bypass operations were performed in 13 patients with complex intracranial aneurysms. There were 6 ruptured aneurysms, including blood blister-like aneurysms in 3 patients, giant aneurysms in 2 patients, and fusiform dissecting aneurysm in 1 patient. Among 7 patients with unruptured aneurysms, there were 5 giant aneurysms and 2 large fusiform aneurysms in the M2 segment.
  
  
  RESULTS
  Parent artery occlusion with endovascular coiling (3 patients) or trapping by direct clipping (10 patients) was used to treat complex cerebral aneurysms. Complete occlusion of the aneurysm was demonstrated in 11 patients (85%); the other 2 patients did not demonstrate occlusion immediately postoperatively. Except for 2 patients who presented with poor-grade subarachnoid hemorrhage, patients (n = 11; 85%) demonstrated good scores on the Glasgow Outcome Scale. No new neurologic deficits developed in relation to insufficient blood flow through the bypass graft. In all 13 patients, graft patency was good at long-term follow-up (overall mean follow-up, 28.2 months).
  
  
  CONCLUSIONS
  Superficial temporal artery-middle cerebral artery bypass surgery using a short interposition graft for intracranial complex aneurysms seems to be safe and efficient hemodynamically after occlusion of the parent artery. It could be regarded as a good alternative to high-flow bypass surgery.
authors.affiliation: Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kuhyun
authors.initials: K
authors.lastname: Yang
authors.affiliation: Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: jsahn@amc.seoul.kr.
authors.forename: Jae Sung
authors.initials: JS
authors.lastname: Ahn
authors.affiliation: Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jung Cheol
authors.initials: JC
authors.lastname: Park
authors.affiliation: Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Kwon
authors.affiliation: Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Byung Duk
authors.initials: BD
authors.lastname: Kwun
authors.affiliation: Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000601:surgery; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000379:methods*; D002560:Cerebrovascular Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D017534:Radial Artery / Q000637:transplantation; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Bypass surgery; Complex intracranial aneurysm; Short interposition graft; Superficial temporal artery