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In situ interposition bypass for complex intracranial aneurysms: A single-center experience and efficacy analysis

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Abstract

The purpose of this study was to investigate the application and efficacy analysis of in situ interposition bypass in complex intracranial aneurysms. This study retrospectively analyzed the clinical data of 21 patients with complex intracranial aneurysms treated with in situ interposition bypass grafting in the Department of Neurosurgery at Tianjin Huanhu Hospital from June 2015 to December 2022. The aneurysms were located in the middle cerebral artery in 16 cases, the anterior cerebral artery in 3 cases, the posterior cerebral artery in 1 case, and the posterior inferior cerebellar artery in 1 case. The interposition graft vessels were taken from the radial artery in 15 cases, the superficial temporal artery in 5 cases, and the occipital artery in 1 case. All patients underwent end-to-end anastomosis with in situ interposition bypass after aneurysm resection, including 13 cases of "I-shaped" type, 5 cases of "V-shaped" type, and 3 cases of "Y-shaped" type. Postoperative digital subtraction angiography (DSA) or computed tomography angiography (CTA) reviews were performed for all the patients, and modified Rankin Scale (mRS) score was used to assess patient prognosis. Three patients developed postoperative basal ganglia infarction and two of them recovered well. One case developed transient incomplete aphasia and one case developed mild hemiparesis, which recovered well after 3 months. The remaining 16 patients did not develop new neurological deficits. Postoperative DSA or CTA showed that the anastomosis of the bypass graft and the graft vessels were patent, and all aneurysms were completely eliminated. Regular postoperative follow-up ranged from 3 to 89 months, and no aneurysm recurred. The percentage of patients with mRS ≤ 2 at the final follow-up was 90.5%. Based on the experience of surgical treatment in our center, in situ interposition bypass technique is a safe and effective option for the treatment of some complex intracranial aneurysms.

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The data and materials supporting this study can be obtained from the corresponding author upon reasonable request.

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Acknowledgements

We thank Hong Ji and Jie Qiao for clinical data support and all the patients treated in our medical center.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. School of Medicine, Nankai University, 94 Weijin Road, Tianjin, 300071, China

    Meng Zhang & Xiaoguang Tong

  2. Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China

    Xingdong Wang

  3. School of Medicine, Nankai University, Huanhu Hospital Affiliated to Nankai University. Department of Neurosurgery, Tianjin Huanhu Hospital, No.6, Jizhao Road, Jinnan District, Tianjin, China

    Xiaoguang Tong

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Contributions

The corresponding author Xiaoguang Tong contributed to the study conception and design. Material preparation, data collection and analysis were performed by Meng Zhang and Xingdong Wang. The first draft of the manuscript was written by Meng Zhang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xiaoguang Tong.

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Zhang, M., Wang, X. & Tong, X. In situ interposition bypass for complex intracranial aneurysms: A single-center experience and efficacy analysis. Neurosurg Rev 47, 32 (2024). https://doi.org/10.1007/s10143-023-02266-z

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