title: Surgical Treatment of Complex Cerebral Aneurysms Using Interposition Short Vein Graft.
abstract: Cerebral revascularization strategies may become necessary in select patients who present with challenging cerebral aneurysms. In this study, we present the techniques of a moderate-flow extra-intracranial bypass using a short interposition vein graft and concurrent aneurysm management.
  
  
  
  The short interposition vein graft was used for the reconstruction of complex cerebral aneurysms in nine patients. In eight of them, the superficial temporal artery (STA) main trunk was used as a donor site for the anastomosis of a short interposition vein graft, and an extracranial vertebral artery (VA) was used in one case. The vein grafts were implanted into the M2 of the middle cerebral artery (MCA) for the adjunctive treatment of internal carotid artery (ICA) aneurysms in three patients, into the A3 of the anterior cerebral artery (ACA) in one patient, into the P2 of the posterior cerebral artery (PCA) for the adjunctive treatment of complex PCA aneurysms in three patients, into the P3 of the PCA for the adjunctive treatment of a basilar artery (BA) trunk giant aneurysm in 1 patient, and into the postero-inferior cerebellar artery (PICA) for the adjunctive treatment of the VA dissecting aneurysm in one patient.
  
  
  
  All of the bypasses were patent. Intraoperative flow measurements confirmed a moderate flow-carrying capacity of the short interposition short vein graft (30-70 ml; mean: 43 ml/min).
  
  
  
  The STA main trunk to proximal MCA/PCA bypass and the extracranial VA to PICA bypass using short interposition vein grafts can provide sufficient blood flow and may be a reasonable alternative to the conventional EC-IC bypass/high-flow bypass.
authors.affiliation: Department of Neurosurgery, Asahi University Murakami Memorial Hospital, Hashimoto-cho 3-23, Gifu, 500-8523, Japan. kaku@murakami.asahi-u.ac.jp.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kaku
authors.affiliation: Department of Neurosurgery, Asahi University Murakami Memorial Hospital, Hashimoto-cho 3-23, Gifu, 500-8523, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takei
authors.affiliation: Department of Neurosurgery, Asahi University Murakami Memorial Hospital, Hashimoto-cho 3-23, Gifu, 500-8523, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Miyai
authors.affiliation: Department of Neurosurgery, Asahi University Murakami Memorial Hospital, Hashimoto-cho 3-23, Gifu, 500-8523, Japan.
authors.forename: Kentarou
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Neurosurgery, Asahi University Murakami Memorial Hospital, Hashimoto-cho 3-23, Gifu, 500-8523, Japan.
authors.forename: Jouji
authors.initials: J
authors.lastname: Kokuzawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000379:methods*; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D013699:Temporal Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D058017:Vascular Grafting / Q000379:methods*; D020217:Vertebral Artery Dissection / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Complex cerebral aneurysm; EC-IC bypass; Short vein graft