Saphenous vein graft reconstruction of an unclippable giant basilar artery aneurysm performed with the patient under deep hypothermic circulatory arrest: technical case report

Neurosurgery
Laligam N SekharD Alyono

Abstract

Effective treatment for unclippable giant vertebrobasilar aneurysms remains unclear. We present the first reported case of a giant vertebrobasilar aneurysm being successfully treated with trapping of the aneurysm and internal carotid artery to basilar artery bypass with a saphenous vein graft that was performed with the patient under hypothermic circulatory arrest. A 15-year-old female patient with a history of probable subarachnoid hemorrhage and chronic headaches presented with a relatively acute exacerbation of her headache, nausea, vomiting, and weakness. Imaging studies revealed a 4 x 4 x 3-cm vertebrobasilar aneurysm, supplied by an angiographically dominant right vertebral artery and causing significant brain stem compression. Initially, a petrosal approach with a hearing-preserving partial labyrinthectomy was used to perform a right external carotid artery to posterior cerebral artery bypass with saphenous vein. Delayed occlusion of the right vertebral artery with an intraluminal balloon was planned; however, intraoperative angiography revealed poor graft flow, presumably because of the small size of the posterior cerebral artery. Postoperative graft occlusion was anticipated. During this same time interval, the patient...Continue Reading

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Citations

Jan 22, 2005·Journal of Neurosurgery·Masatou KawashimaKiyotaka Fujii
Apr 4, 2006·Neurosurgery·Michael T Lawton, Alfredo Quiñones-Hinojosa
Aug 23, 2011·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Bai-Nan XuBao-Min Li
Jul 24, 2004·Neurosurgery·Boris LubiczJean-Pierre Pruvo
Mar 5, 2013·Journal of Neurosurgery. Pediatrics·Louis J KimLaligam N Sekhar
Feb 16, 2008·Neurosurgical Focus·R Webster CrowleyAaron S Dumont
Aug 22, 2008·Neurosurgery·Laligam N SekharBasavaraj Ghodke
Apr 7, 2017·Neurosurgery·David C StrausLaligam N Sekhar
Feb 14, 2007·Neurosurgery·Alex A MohitBasavaraj Ghodke
Feb 15, 2002·Neurosurgery·Laligam N Sekhar, Chandrasekar Kalavakonda

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