scholarly journals Management of Ruptured Anterior Wall Aneurysm of the Internal Carotid Artery with High-flow Bypass Using a Radial Artery Graft

2017 ◽  
Vol 45 (6) ◽  
pp. 432-438
Author(s):  
Gakushi YOSHIKAWA ◽  
Kazuo TSUTSUMI
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Radial Artery ◽  
Internal Carotid ◽  
Anterior Wall ◽  
High Flow ◽  
Radial Artery Graft ◽  
Artery Graft

scholarly journals High flow bypass for right giant cavernous internal carotid artery aneurysm with fibromuscular dysplasia of cervical internal carotid artery: microsurgical 2-D video

2020 ◽  
Vol 11 ◽  
pp. 177
Author(s):  
Miguel Angel Lopez-Gonzalez ◽  
Xiaochun Zhao ◽  
Dinesh Ramanathan ◽  
Timothy Marc Eastin ◽  
Song Minwoo
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Radial Artery ◽  
Fibromuscular Dysplasia ◽  
Internal Carotid ◽  
High Flow ◽  
Oculomotor Nerve Palsy ◽  
Radial Artery Graft ◽  
Artery Graft ◽  
Cervical Internal Carotid Artery

Background: It is well known that intracranial aneurysms can be associated to fibromuscular dysplasia (FMD). Nevertheless, it is not clear the best treatment strategy when there is an association of giant symptomatic cavernous carotid aneurysm with extensive cervical internal carotid artery (ICA) FMD. Case Description: We present the case of 63 year-old right-handed female with hypothyroidism, 1 month history of right-sided pulsatile headache and visual disturbances with feeling of fullness sensation and blurry vision. Her neurological exam showed partial right oculomotor nerve palsy with mild ptosis, asymmetric pupils (right 5 mm and left 3mm, both reactive), and mild exotropia, normal visual acuity. Computed tomography angiogram and conventional angiogram showed 2.5 × 2.6 × 2.6 cm non-ruptured aneurysm arising from cavernous segment of the right ICA. She had right hypoplastic posterior communicant artery, and collateral flow through anterior communicant artery during balloon test occlusion and the presence of right cervical ICA FMD. The patient was started on aspirin. After lengthy discussion of treatment options in our neurovascular department, between observations, endovascular treatment with flow diverter device, or high flow bypass, recommendation was to perform high flow bypass and patient consented for the procedure. We performed right-sided pterional trans-sylvian microsurgical approach and right neck dissection at common carotid bifurcation under electrophysiology monitoring (somatosensory evoked potentials and electroencephalography); while vascular surgery department assisted with the radial artery graft harvesting. The radial artery graft was passed through preauricular tunnel, cranially was anastomosed at superior trunk of middle cerebral artery, and caudally at external carotid artery (Video). Intraoperative angiogram showed adequate bypass patency and lack of flow within aneurysm. The patient was extubated postoperatively and discharged home with aspirin in postoperative day 5. Improvement on oculomotor deficit was complete 3 weeks after surgery. Conclusion: Nowadays, endovascular therapy can manage small to large cavernous ICA aneurysms even if associated to FMD, although giant symptomatic cavernous carotid aneurysms impose a different challenge. Here, we present the management for the association of symptomatic giant cavernous ICA aneurysm and cervical ICA FMD with high flow bypass. We consider important to keep the skills in the cerebrovascular neurosurgeon armamentarium for the safe management of these lesions.

scholarly journals Posttraumatic Carotid-Cavernous Fistulae Treated by Internal Carotid Artery Trapping and High-Flow Bypass Using a Radial Artery Graft

2011 ◽  
Vol 51 (2) ◽  
pp. 113-116 ◽  
Author(s):  
Takayuki MIZUNARI ◽  
Yasuo MURAI ◽  
Kyongsong KIM ◽  
Shiro KOBAYASHI ◽  
Hiroyasu KAMIYAMA ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Radial Artery ◽  
Internal Carotid ◽  
High Flow ◽  
Radial Artery Graft ◽  
Artery Graft

Long-term patency of radial artery graft bypass for reconstruction of the internal carotid artery

1999 ◽  
Vol 90 (4) ◽  
pp. 786-790 ◽  
Author(s):  
Kiyohiro Houkin ◽  
Hiroyasu Kamiyama ◽  
Satoshi Kuroda ◽  
Tatsuya Ishikawa ◽  
Akihiro Takahashi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Radial Artery ◽  
Internal Carotid ◽  
Radial Artery Graft ◽  
Conventional Angiography ◽  
Content Type ◽  
Artery Graft ◽  
Fine Print

✓ Reconstruction of the carotid artery by using a radial artery graft is a useful option that can produce reliable long-term patency for the surgical treatment of giant and/or large aneurysms of the cavernous and paraclinoid internal carotid artery (ICA).During the past 10 years, 43 patients with intracavernous and paraclinoid giant aneurysms of the ICA have been treated by reconstruction of the ICA with radial artery grafts after ligation of the cervical ICA. The long-term patency of the grafted radial artery was evaluated over more than a 5-year period (mean 7.2 years) in 20 of these patients by using magnetic resonance angiography or conventional angiography. There was no late occlusion of the graft in any of these cases. Stenotic graft changes were observed in two cases.

scholarly journals Trapping and Radial Artery Graft Bypass Surgery for Internal Carotid Artery Aneurysms

2007 ◽  
Vol 35 (3) ◽  
pp. 198-203 ◽  
Author(s):  
Toshiaki OSATO ◽  
Jyoji NAKAGAWARA ◽  
Takehiko SASAKI ◽  
Taketo KATAOKA ◽  
Kenji KAMIYAMA ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Radial Artery ◽  
Bypass Surgery ◽  
Internal Carotid ◽  
Radial Artery Graft ◽  
Artery Graft

scholarly journals Long-term Outcomes of Internal Carotid Artery Disease Treated Using Radial Artery Graft

2009 ◽  
Vol 37 (5) ◽  
pp. 369-374 ◽  
Author(s):  
Yasuo MURAI ◽  
Takayuki MIZUNARI ◽  
Shiro KOBAYASHI ◽  
Katsuya UMEOKA ◽  
Kojiro TATEYAMA ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Radial Artery ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Long Term Outcomes ◽  
Radial Artery Graft ◽  
Artery Graft ◽  
Artery Disease

Subclavian Artery to Internal Carotid Artery Interpositional Bypass for Carotid Artery Occlusion: Technical Case Report

2020 ◽  
Vol 20 (1) ◽  
pp. E66-E71
Author(s):  
Joshua S Catapano ◽  
Fabio A Frisoli ◽  
Gabriella M Paisan ◽  
Katherine A Dunn ◽  
Ankush Bajaj ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Radial Artery ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Radial Artery Graft ◽  
Artery Graft

Abstract BACKGROUND AND IMPORTANCE Conventional microsurgical treatment for symptomatic internal carotid artery (ICA) occlusion is revascularization with superficial temporal artery (STA) to middle cerebral artery bypass. However, in rare cases where the common carotid artery, external carotid artery (ECA), or both are also occluded, other microsurgical treatment options must be considered. CLINICAL PRESENTATION We present the case of a 52-yr-old woman with common carotid artery occlusion and weak ICA flow from collateral connections between the vertebral artery, occipital artery, and ECA. She had ischemic symptoms and a history of stroke. The patient's STA was unsuitable as a donor vessel due to its small caliber and poor flow, and we instead performed an interpositional bypass from the subclavian artery to the ICA using a radial artery graft. CONCLUSION This case illustrates the successful use of the subclavian artery to ICA bypass technique with an interpositional radial artery graft. The surgical anatomy of the subclavian arteries is reviewed, and the technical details of subclavian artery to radial artery graft to ICA interpositional bypass are presented.

Use of “Bonnet” Bypass with Radial Artery Interposition Graft in a Patient with Recurrent Cranial Base Carcinoma: Technical Report of Two Cases and Review of the Literature

2005 ◽  
Vol 56 (suppl_1) ◽  
pp. ONS-E202-ONS-E202 ◽  
Author(s):  
Vivek R. Deshmukh ◽  
Randall W. Porter ◽  
Robert F. Spetzler
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Radial Artery ◽  
Internal Carotid ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Cranial Base ◽  
Radial Artery Graft ◽  
Artery Graft

Abstract OBJECTIVE AND IMPORTANCE: Two patients with recurrent cranial base carcinomas involving the carotid artery received a “bonnet” bypass using the contralateral superficial temporal artery as the donor vessel because the ipsilateral common and external carotid arteries were unavailable. The radial artery was used as the graft. CLINICAL PRESENTATION: A 58-year-old man with ear pain and an enlarging mass involving the left cranial base and neck had undergone a right partial glossectomy and modified neck dissection followed by radiotherapy for squamous cell carcinoma. Recurrent carcinoma extensively involved the left internal carotid artery. A 46-year-old man with jaw pain and hoarseness had undergone multiple resections and radiation therapy for medullary thyroid carcinoma. Magnetic resonance imaging showed recurrent tumor on the right. INTERVENTION: Both patients underwent a pterional craniotomy. The supraclinoid internal carotid artery was exposed. The radial artery was harvested. The contralateral superficial temporal artery was dissected at its bifurcation into the frontal and parietal branches. The radial artery graft was anastomosed to the superficial temporal artery and a recipient ipsilateral branch of the middle cerebral artery. The internal carotid artery was clip-ligated. After surgery, both patients remained neurologically stable. Angiography confirmed that the bypasses were patent and that the middle cerebral artery territory filled. The patients’ carcinomas were resected aggressively. CONCLUSION: When aggressive resection of cranial base tumors is needed and the ipsilateral carotid artery is unavailable as a donor vessel, a “bonnet” bypass with carotid artery sacrifice may be performed. Compared with vein grafts, microsurgical anastomosis is easier and the patency rate is higher with a radial artery graft.

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