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Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series

  • Authors:
    • Xiaocheng Lu
    • Yabo Huang
    • Peng Zhou
    • Weiwei Zhu
    • Zhong Wang
    • Gang Chen
  • View Affiliations / Copyright

    Affiliations: Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
    Copyright: © Lu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 883
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    Published online on: June 15, 2021
       https://doi.org/10.3892/etm.2021.10315
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Abstract

Complex middle cerebral artery (MCA) aneurysms, including aneurysms that are sizeable (large or giant), fusiform, wide‑necked or calcified, remain a significant challenge during microsurgical clipping or endovascular coiling as treatment strategies. In the present study, a retrospective analysis of cases of this type of aneurysm treated between August 2012 and December 2019 was performed. From the hospital's database, a total of 13 patients (7 males and 6 females) with a mean age of 39.0 years (range, 13‑65 years) were identified. The mean size of the aneurysms was 17.5 mm (range, 3.9‑35.0 mm). A total of four patients (30.8%) had ruptured aneurysms and nine (69.2%) had unruptured aneurysms. All aneurysms were treated by proximal occlusion of the parent artery, trapping or excision combined with cerebral revascularization. The bypasses performed included 10 extracranial‑intracranial bypasses and 3 intracranial‑intracranial bypasses (1 end‑to‑end re‑anastomosis, 1 interpositional graft and 1 end‑to‑side reimplantation). Postoperative angiography confirmed that the bypass patency was 92.3% and the clinical outcomes were indicated to be favorable, with a modified Rankin Scale score ≤2 in 12 out of 13 patients (92.3%) at the last follow‑up. Taken together, the results of the present analysis suggested that treatment strategies for complex MCA aneurysms should depend on the status and characteristics of the aneurysm, including aneurysm size, location and morphology. For aneurysms that lack perforating arteries in the aneurysm dome, clip trapping or aneurysm excision with or without bypass are preferred as treatment strategies. When there are perforating arteries (particularly the lenticulostriate artery) arising from the aneurysm dome, however, the aneurysms should be treated with bypass followed by proximal occlusion of the parent artery or clip reconstruction.
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Copy and paste a formatted citation
Spandidos Publications style
Lu X, Huang Y, Zhou P, Zhu W, Wang Z and Chen G: Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series. Exp Ther Med 22: 883, 2021.
APA
Lu, X., Huang, Y., Zhou, P., Zhu, W., Wang, Z., & Chen, G. (2021). Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series. Experimental and Therapeutic Medicine, 22, 883. https://doi.org/10.3892/etm.2021.10315
MLA
Lu, X., Huang, Y., Zhou, P., Zhu, W., Wang, Z., Chen, G."Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series". Experimental and Therapeutic Medicine 22.2 (2021): 883.
Chicago
Lu, X., Huang, Y., Zhou, P., Zhu, W., Wang, Z., Chen, G."Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series". Experimental and Therapeutic Medicine 22, no. 2 (2021): 883. https://doi.org/10.3892/etm.2021.10315
Copy and paste a formatted citation
x
Spandidos Publications style
Lu X, Huang Y, Zhou P, Zhu W, Wang Z and Chen G: Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series. Exp Ther Med 22: 883, 2021.
APA
Lu, X., Huang, Y., Zhou, P., Zhu, W., Wang, Z., & Chen, G. (2021). Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series. Experimental and Therapeutic Medicine, 22, 883. https://doi.org/10.3892/etm.2021.10315
MLA
Lu, X., Huang, Y., Zhou, P., Zhu, W., Wang, Z., Chen, G."Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series". Experimental and Therapeutic Medicine 22.2 (2021): 883.
Chicago
Lu, X., Huang, Y., Zhou, P., Zhu, W., Wang, Z., Chen, G."Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series". Experimental and Therapeutic Medicine 22, no. 2 (2021): 883. https://doi.org/10.3892/etm.2021.10315
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