scholarly journals Current neurosurgical indications for saphenous vein graft bypass

2003 ◽  
Vol 14 (3) ◽  
pp. 1-3 ◽  
Author(s):  
Jonathan A. Friedman ◽  
David G. Piepgras
Keyword(s):  
Saphenous Vein ◽  
Vein Graft ◽  
Intracranial Aneurysms ◽  
Saphenous Vein Graft ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Occlusive Disease ◽  
Valuable Component ◽  
Vascular Bypass ◽  
Endovascular Technology

Object Vascular bypass is performed in neurosurgery for a variety of pathological entities, including extracranial atherosclerotic disease, extra- and intracranial aneurysms, and tumors involving the carotid artery (CA) at the skull base or cervical regions. Creation of an interposition saphenous vein graft (SVG) is the typical method of choice when the superficial temporal artery is not an option. Methods One hundred thirty consecutive patients treated with SVG between July 1988 and December 2002 at the Mayo Clinic were studied. A total of 130 procedures were performed in 130 patients. The indications were intracranial aneurysm in 51 patients (39%), CA occlusive disease in 36 (28%), extracranial CA aneurysm in 17 (13%), tumors involving the cervical CA in 11 (8%), vertebral artery occlusive disease in eight (6%), and other indications in six patients (5%). Among patients treated for intracranial aneurysms, 43 harbored giant aneurysms (> 25 mm in widest diameter) whereas the remaining eight patients harbored aneurysms that were large (15–25 mm in widest diameter). Among patients with CA occlusive disease, high-grade stenosis at the CA bifurcation was present in 29 and CA occlusion was demonstrated in seven. Conclusions The use of SVG bypass remains a valuable component of the neurosurgical armamentarium for a variety of pathological entities. Despite a general trend toward decreased use because of improved endovascular technology, surgical facility with this procedure should be maintained.

scholarly journals Saphenous vein graft bypass in the treatment of giant cavernous sinus aneurysms: report of two cases

2000 ◽  
Vol 58 (1) ◽  
pp. 162-168 ◽  
Author(s):  
RICARDO RAMINA ◽  
MURILO S. MENESES ◽  
ARI A PEDROZO ◽  
WALTER O. ARRUDA ◽  
GUILHERME BORGES
Keyword(s):  
Carotid Artery ◽  
Cavernous Sinus ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Brain Infarction ◽  
Superficial Temporal Artery ◽  
High Flow ◽  
Low Flow ◽  
External Carotid

Two cases of giant intracavernous aneurysms treated by high flow bypass with saphenous vein graft between the external carotid artery (ECA) and branches of the middle cerebral artery (MCA) are presented. Very often these aneurysms are unclippable because they are fusiform or have a large neck. Occlusion of the internal carotid artery (ICA) is the treatment of choice in many cases. This procedure has however a high risk of brain infarction. Revascularization of the brain by extra-intracranial anastomosis between the superficial temporal artery (STA) and branches of the MCA is frequently performed. This procedure provides however a low flow bypass and brain infarction may occur. We report two cases of giant cavernous sinus aneurysms treated by high flow bypass and endovascular balloon occlusion of the ICA. Immediate high flow revascularization of MCA branches was achieved and the patients showed no ischemic events. Follow-up of 8 and 14 months after operation shows patency of the venous graft and no neurological deficits. Angiographic control examination showed complete aneurysm occlusion in both cases.

Safety of early endovascular catheterization and intervention through extracranial-intracranial bypass grafts

2012 ◽  
Vol 116 (1) ◽  
pp. 201-207 ◽  
Author(s):  
Omar M. Qahwash ◽  
Ali Alaraj ◽  
Victor Aletich ◽  
Fady T. Charbel ◽  
Sepideh Amin-Hanjani
Keyword(s):  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Endovascular Intervention ◽  
Bypass Grafts ◽  
Intraarterial Infusion ◽  
Endovascular Interventions ◽  
Anastomotic Disruption ◽  
The Common

Object The goal of this study was to demonstrate feasibility and evaluate technical aspects of early endovascular access through extracranial-intracranial (EC-IC) bypass grafts. Methods Patients undergoing endovascular interventions through the graft in the acute postoperative period following EC-IC bypass are presented. Results, complications, and technical nuances are reviewed. Results Fourteen endovascular procedures were performed in 5 patients after EC-IC bypass for ruptured aneurysms in 4 patients and posterior circulation ischemia in 1 patient. In 2 patients, a saphenous vein graft (SVG) was used to bypass the common carotid artery (CCA) to the middle cerebral artery (MCA). One patient underwent a superficial temporal artery (STA)–MCA bypass, and in 2 other patients the STA stump was connected to the intracranial circulation via an interposition SVG. The interval from surgery to endovascular intervention spanned 2–18 days; the indication was intracranial vasospasm in all patients. One case involved angioplasty of the proximal anastomosis on postoperative Day 14. All other interventions entailed proximal access through the bypass conduit for intraarterial infusion of vasodilators. Significant vasospasm of the STA itself was encountered in 2 patients during endovascular manipulation, and it was treated with intraarterial nitroglycerin. There were no cases of anastomotic disruption. Conclusions Endovascular catheterization and intervention involving a recent EC-IC bypass is feasible. The main limitation in this series was catheter-induced vasospasm involving the STA. A vein graft may be the more appropriate option in patients with subarachnoid hemorrhage who may require subsequent endovascular intervention for vasospasm.

New technique for tunneling of reversed saphenous vein graft to prevent kinking and twisting during vascular bypass procedures

2013 ◽  
Vol 29 (4) ◽  
pp. 274-275
Author(s):  
Vikas Deep Goyal ◽  
Shelly Rana ◽  
Sanjeev Sharma ◽  
Shalini Sharma ◽  
Ashwani Kumar
Keyword(s):  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
New Technique ◽  
Vascular Bypass

scholarly journals High-flow bypass using saphenous vein grafts with trapping of ruptured blood blister-like aneurysms of the internal carotid artery: patient series

2021 ◽  
Vol 2 (18) ◽  
Author(s):  
Taichi Ishiguro ◽  
Koji Yamaguchi ◽  
Tatsuya Ishikawa ◽  
Daiki Ottomo ◽  
Takayuki Funatsu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Saphenous Vein ◽  
Internal Carotid ◽  
Saphenous Vein Graft ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
High Flow ◽  
Ability To Act ◽  
Scale Scores

BACKGROUND Trapping an aneurysm after the establishment of an extracranial to intracranial high-flow bypass is considered the optimal surgical strategy for ruptured blood blister–like aneurysms (BBAs) of the internal carotid artery (ICA). For high-flow bypass surgeries, a radial artery graft is generally preferred over a saphenous vein graft (SVG). However, SVGs can be advantageous in acute-phase surgeries because of their greater length, easy manipulability, ability to act as high-flow conduits, and reduced risk of vasospasms. In this study, the authors presented five cases of ruptured BBAs treated with high-flow bypass using an SVG followed by BBA trapping, and they reported on surgical outcomes and operative nuances that may help avoid potential pitfalls. OBSERVATIONS After the surgeries, there were no ischemic or hemorrhagic complications, including symptomatic vasospasms. In three of the five cases, postoperative modified Rankin scale scores were between 0 and 2 at the 3-month follow-up. In one case, the SVG spontaneously occluded after surgery while the protective superficial temporal artery (STA) to middle cerebral artery (MCA) bypass became dominant, and the patient experienced no ischemic symptoms. LESSONS High-flow bypass using an SVG with a protective STA-MCA bypass followed by BBA trapping is a safe and effective treatment strategy.

Aneurysm of Aortocoronary Saphenous Vein Graft:

2004 ◽  
Vol 7 (4) ◽  
pp. E317-E320 ◽  
Author(s):  
Julie Mayglothling ◽  
Matthew P. Thomas ◽  
Joseph B. Nyzio ◽  
Michael D. Strong ◽  
Louis E. Samuels
Keyword(s):  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft

Saphenous Vein Graft Aneurysm—An Unusual Cause of Mediastinal Mass

2011 ◽  
Vol 9 (1) ◽  
pp. 52 ◽  
Author(s):  
Daniel D Correa de Sa ◽  
Thais Coutinho ◽  
Paul Sorajja ◽  
◽  
◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Vein Graft ◽  
Mediastinal Mass ◽  
Saphenous Vein Graft
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