Natural Y-shaped radial artery graft bypass for a complex middle cerebral artery aneurysm: A case report.


Journal

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633

Informations de publication

Date de publication:
Jul 2020
Historique:
received: 09 01 2020
revised: 25 03 2020
accepted: 29 03 2020
pubmed: 12 5 2020
medline: 21 10 2020
entrez: 12 5 2020
Statut: ppublish

Résumé

Giant thrombosed middle cerebral artery (MCA) aneurysms are difficult to treat and sometimes require complex revascularization using allografts. We describe a technical method using revascularization with a natural Y-shaped graft that provides a normal variation for a complex MCA aneurysm. A 65-year-old man with a giant thrombosed MCA aneurysm presented with right hemiparesis and aphasia. The patient had a history of clipping surgery for the ipsilateral side of the MCA aneurysm 25 years before, and a de novo aneurysm developed over the previous 18 years. For the giant thrombosed aneurysm, trapping and revascularization were performed. A natural radial artery Y-graft was used as the graft and anastomosed to both M2 trunks. The symptoms improved after surgery, and the patient was discharged 3 weeks later. This is the first report of a double-barrel bypass using a natural Y-graft. This method attained a normal variation, and the flow of the Y-graft was physiological. For the radical cure of giant thrombosed MCA aneurysms, multiple revascularizations might be required. With this natural Y-graft, complex transpositions could be avoided.

Identifiants

pubmed: 32389556
pii: S1052-3057(20)30244-5
doi: 10.1016/j.jstrokecerebrovasdis.2020.104853
pii:
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

104853

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Ryota Sato (R)

Department of Neurosurgery, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.

Takeshi Mikami (T)

Department of Neurosurgery, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan. Electronic address: tmikami@sapmed.ac.jp.

Hime Suzuki (H)

Department of Neurosurgery, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.

Akinori Yamamura (A)

Department of Neurosurgery, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan; Department of Neurosurgery, Shinsapporo Neurosurgical Hospital, Sapporo, Japan. Electronic address: yamamura@snh.or.jp.

Yusuke Kimura (Y)

Department of Neurosurgery, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan. Electronic address: ykimura@sapmed.ac.jp.

Ryo Ukai (R)

Department of Neurosurgery, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan. Electronic address: ry-ukai@tf6.so-net.ne.jp.

Tomoaki Tamada (T)

Department of Neurosurgery, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan. Electronic address: tamago1138@hotmail.co.jp.

Yuka Kawata (Y)

Department of Neurosurgery, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.

Yukinori Akiyama (Y)

Department of Neurosurgery, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan. Electronic address: akiyuki@sapmed.ac.jp.

Nobuhiro Mikuni (N)

Department of Neurosurgery, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan. Electronic address: mikunin@sapmed.ac.jp.

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