Combined microsurgical and endovascular treatment of a giant left middle cerebral artery aneurysm.

Journal Article (Journal Article)

Giant fusiform aneurysms of the middle cerebral artery (MCA) bifurcation pose significant treatment challenges. A giant fusiform aneurysm of the left MCA in a pediatric patient, which persisted despite Hunterian ligation of the M1 and double barrel superficial temporal artery (STA) to M2 bypasses, is reported. The aneurysm was trapped by endovascular coiling of the feeding M2 trunk through the STA anastamosis. Hunterian ligation combined with extracranial-intracranial bypass is an effective technique for treating giant fusiform aneurysms of the MCA bifurcation for patients who fail balloon test occlusions. However, in certain cases, flow reversal may not eliminate the aneurysm and continued aneurysm filling may occur through retrograde filling from the bypass recipient vessels. In these cases, endovascular trapping of the aneurysm may be undertaken through the bypass graft. The feasibility of this management scheme is demonstrated.

Full Text

Duke Authors

Cited Authors

  • Zomorodi, A; Bulsara, KR; Friedman, AH; Alexander, MJ

Published Date

  • September 2010

Published In

Volume / Issue

  • 2 / 3

Start / End Page

  • 213 - 216

PubMed ID

  • 21990628

Electronic International Standard Serial Number (EISSN)

  • 1759-8486

Digital Object Identifier (DOI)

  • 10.1136/jnis.2009.001883


  • eng

Conference Location

  • England