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Treatment of giant cavernous aneurysm in an elderly patient via extracranial-intracranial saphenous vein bypass graft in a hybrid operating room: A case report.

Abstract Extracranial-intracranial saphenous vein bypass (EC-IC SVB) remains indispensable for treating giant cavernous aneurysms. We report an unusual case of a giant cavernous aneurysm in an elderly patient treated with EC-IC SVB in a hybrid operating room. Immediately following proximal ligation of the internal carotid artery (ICA), she suffered an acute intraoperative encephalocele.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29620651
OWN - NLM
STAT- MEDLINE
DCOM- 20180416
LR  - 20180416
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 14
DP  - 2018 Apr
TI  - Treatment of giant cavernous aneurysm in an elderly patient via
      extracranial-intracranial saphenous vein bypass graft in a hybrid operating room:
      A case report.
PG  - e0295
LID - 10.1097/MD.0000000000010295 [doi]
AB  - RATIONALE: Extracranial-intracranial saphenous vein bypass (EC-IC SVB) remains
      indispensable for treating giant cavernous aneurysms. We report an unusual case
      of a giant cavernous aneurysm in an elderly patient treated with EC-IC SVB in a
      hybrid operating room. Immediately following proximal ligation of the internal
      carotid artery (ICA), she suffered an acute intraoperative encephalocele. PATIENT
      CONCERNS: A 71-year-old woman had suffered from severe headache and double vision
      for 4 months. DIAGNOSES: The woman was diagnosed with a right giant cavernous
      aneurysm. INTERVENTIONS: She was treated with an EC-IC SVB with therapeutic ICA
      occlusion in the first biplane hybrid operating room in China. Just after
      proximal ligation of the ICA, she developed an acute encephalocele, and
      immediately underwent decompressive craniectomy. During the surgery she underwent
      3 angiographic explorations. OUTCOMES: After surgery, the aneurysm disappeared,
      and the graft was patent. Postoperative computed tomography and computed
      tomography angiography indicated a cranial defect and graft patency. LESSONS:
      Although a hybrid operating room could improve the patency of grafts, the timing 
      of ICA ligation for giant cavernous aneurysm via EC-IC bypass deserves further
      discussion. Second-stage ICA occlusion could offer an alternative for elderly
      patients requiring such treatment. In addition, cranial flap removal could
      prevent further neurologic deficits in a case of acute intraoperative
      encephalocele.
FAU - Xin, Can
AU  - Xin C
AD  - Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan
      University, Wuhan, China.
FAU - Zhang, Jianjian
AU  - Zhang J
FAU - Li, Zhengwei
AU  - Li Z
FAU - Xiong, Zhongwei
AU  - Xiong Z
FAU - Yang, Bangkun
AU  - Yang B
FAU - Wu, Xiaolin
AU  - Wu X
FAU - Wang, Hao
AU  - Wang H
FAU - Zou, Yichun
AU  - Zou Y
FAU - Wu, Rongqing
AU  - Wu R
FAU - Zhao, Wenyuan
AU  - Zhao W
FAU - Chen, Jincao
AU  - Chen J
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Carotid Artery, Internal/*surgery
MH  - Cerebral Revascularization/adverse effects/*methods
MH  - Encephalocele/etiology
MH  - Female
MH  - Humans
MH  - Intracranial Aneurysm/pathology/*surgery
MH  - Intraoperative Complications/etiology
MH  - Ligation/methods
MH  - Operating Rooms
MH  - Saphenous Vein/*transplantation
EDAT- 2018/04/06 06:00
MHDA- 2018/04/17 06:00
CRDT- 2018/04/06 06:00
PHST- 2018/04/06 06:00 [entrez]
PHST- 2018/04/06 06:00 [pubmed]
PHST- 2018/04/17 06:00 [medline]
AID - 10.1097/MD.0000000000010295 [doi]
AID - 00005792-201804060-00029 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Apr;97(14):e0295. doi: 10.1097/MD.0000000000010295.