Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.
Research Department, Jacksonville University, Jacksonville, Florida, USA.
Oper Neurosurg (Hagerstown). 2022 Dec 1;23(6):e382-e386. doi: 10.1227/ons.0000000000000391. Epub 2022 Sep 19.
Anastomotic aneurysms are widely described in the cardiac literature; however, they have been less frequently reported in the neurological field. Historically, neurosurgeons have been treating anastomotic aneurysms arising from the superficial temporal artery to the middle cerebral artery (STA-MCA) bypass with open surgery. We proposed an endovascular treatment for our patient using the stent-assisted coiling technique, achieving good outcomes.
A man in his late forties with symptomatic chronic carotid occlusion underwent direct STA-MCA bypass surgery. On follow-up images, an incidental anastomotic aneurysm was discovered. The risks and benefits of treatment or watchful waiting were addressed, and an endovascular approach was the chosen treatment technique. Such complication is widely described in the cardiac literature; however, it has scarce reports in the neurological field. Furthermore, stent-assisted coiling was performed achieving complete occlusion of the aneurysm maintaining good patency of the bypass.
STA-MCA aneurysm at the site of anastomosis is a potential complication after a direct bypass. Traditional management has been reported using open surgery with clipping or wrapping of the aneurysm. However, we propose endovascular surgery as an alternative approach to such complication, achieving good clinical outcomes.
吻合口动脉瘤在心脏文献中广泛描述，但在神经领域报道较少。历史上，神经外科医生一直采用开颅手术治疗由颞浅动脉到大脑中动脉（STA-MCA）旁路的吻合口动脉瘤。我们对患者采用支架辅助弹簧圈技术进行血管内治疗，取得了良好的效果。
一名四十多岁的男性患有症状性慢性颈动脉闭塞，行直接 STA-MCA 旁路手术。随访图像发现一个偶然的吻合口动脉瘤。讨论了治疗或观察等待的风险和益处，选择了血管内治疗方法。这种并发症在心脏文献中广泛描述，但在神经领域报道较少。此外，进行了支架辅助弹簧圈治疗，实现了动脉瘤的完全闭塞，同时保持旁路的良好通畅性。
直接旁路后吻合口处的 STA-MCA 动脉瘤是一种潜在的并发症。传统的治疗方法是采用开颅手术夹闭或包裹动脉瘤。然而，我们提出血管内手术作为这种并发症的一种替代方法，取得了良好的临床效果。
