We retrospectively identified six patients with complex IAs who underwent clipping and a protective STA-MCA bypass through the LSO approach between January 2016 and December 2020. The STA donor artery was harvested through the same curvilinear skin incision with a small extension, and it was anastomosed to the opercular segment of the MCA. Subsequently, aneurysm clipping followed standardized steps.
Anastomosis was successful in all patients. Despite requiring temporary occlusion of the parent artery, all aneurysms were successfully clipped without any neurological deterioration.
A protective STA-MCA bypass is feasible through the LSO approach with certain technical modifications. This technique helps protect distal cerebral flow for safe clip placement in the treatment of complex IAs with the associated benefits of a less invasive craniotomy.
方法:我们回顾性地确定了6例复杂IAs患者,他们在2016年1月至2020年12月期间通过LSO方法进行了夹闭和保护性STA-MCA旁路手术。STA供体动脉通过相同的曲线皮肤切口采集,并有一个小的延伸,它与MCA的手术段吻合。随后,动脉瘤夹闭遵循标准化步骤。
结果:所有患者吻合均成功。尽管需要暂时封堵父动脉,所有动脉瘤均成功夹闭,无任何神经系统恶化.
结论:通过LSO方法进行某些技术修改,保护性STA-MCA旁路是可行的。该技术有助于在复杂的IAs治疗中保护远端脑血流,以安全地放置夹子,并具有侵入性较小的开颅手术的相关益处。