Format

Send to

Choose Destination
World Neurosurg. 2019 Feb 18. pii: S1878-8750(19)30378-X. doi: 10.1016/j.wneu.2019.01.259. [Epub ahead of print]

Intracranial-intracranial bypass with a graft vessel: a comprehensive review of technical characteristics and surgical experience.

Author information

1
Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery, Stroke Center, Teishinkai Hospital, Sapporo, Japan; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States. Electronic address: wanglong@mail.ccmu.edu.cn.
2
Department of Neurosurgery, The First Affiliated Hospital of University of South China, Hengyang, China; Arkansas Neuroscience Institute, St. Vincent Hospital, Little Rock, Arkansas, United States.
3
Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China.
4
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.
5
Department of Neurosurgery, Stroke Center, Teishinkai Hospital, Sapporo, Japan.
6
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States.
7
Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery, Fuxing Hospital, Capital Medical University, Beijing, China.

Abstract

OBJECTIVE:

Intracranial-intracranial (IC-IC) bypass with a graft vessel (IBGV) is a straightforward arterial reconstruction technique used for the treatment of complex aneurysms and skull base tumors. Here, we describe the technical characteristics and summarize clinical results of IBGV in complex cerebrovascular disorders.

METHODS:

A literature search was performed using the PubMed (https://www.ncbi.nlm.nih.gov/pubmed/) and Google Scholar online databases. The terms "intracranial-intracranial bypass", "jump graft bypass", "interposition graft bypass", "radial artery graft bypass", "saphenous vein graft bypass" and "superficial temporal artery graft bypass" were searched. Articles involving IBGV combined with other bypass methods were excluded. Illustrations of this technique are provided to enhance comprehension.

RESULTS:

Fifty-nine cases involving six types of graft vessels were identified between 1978 and July 2018. The IBGV technique was divided into the following four subtypes: Type IA, in situ interposition graft bypass; Type IB, "Y"-shaped double-barrel interposition graft bypass; Type IIA, long "jump" graft bypass; Type IIB, "Y"-shaped double-barrel "jump" graft bypass. Grafts from the radial (44.1%, 26/59) and superficial temporal (39.3%, 22/59) arteries were used most frequently, and the middle cerebral artery territory was the most commonly involved region in IBGV. Of the cases with specified postoperative characteristics, the graft patency and overall uneventful rates were 96.3% (52/54) and 82.2% (37/45), respectively. A higher patency rate (100% vs 90.5%) and a lower complication rate (<20% vs 60%) were observed in the type II group with arterial graft.

CONCLUSIONS:

The IBGV method is a technically feasible option for vascular diseases or complex cerebral tumors and should be considered by neurosurgeons. Long "jump" bypass with arterial grafts is preferred when intracranial-intracranial bypass is considered due to high rates of graft patency and favorable clinical outcomes.

KEYWORDS:

Complex intracranial aneurysm; complex intracranial aneurysm; in situ interposition graft bypass; intracranial-intracranial bypass; jump graft bypass; radial artery graft bypass; saphenous vein graft bypass; superficial temporal artery graft bypass

PMID:
30790733
DOI:
10.1016/j.wneu.2019.01.259

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center