External Carotid Artery to Middle Cerebral Artery Bypass with Saphenous Vein Graft for a Giant Internal Carotid Artery Aneurysm at the Cavernous Portion.

Jeon, Sang Ryong; Chang, Ung Kyu; Chung, Chun Kee; Han, Dae Han

Original Article

Journal of Korean Neurosurgical Society 1994;23(5): 589-593.

Sang Ryong Jeon, Ung Kyu Chang, Chun Kee Chung, Dae Han Han

Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

The authors reports a case of giant carotid artery aneurysm at the cavernous portion which was treated by trapping of internal carotid artery(ICA) after external carotid artery(ECA) to middle cerebral artery(MCA) bypass by long saphenous vein graft. It was impossible to clip the aneurysm because of its position and size. The patient suffered from progressive extraocular movement disturbance and decreased visual acuity. She was intolerant to ballon occlusion test. The size of the aneurysm was 3.5x2.5x2 cm. ECA to MCA bypass was done with saphenous vein graft successfully. However, computerized tomography shows hemorrhagic infraction at left temporal lobe postoperatively. Two days later, left temporal lobectomy was done because of uncontrollable increased intracranial pressure. Internal carotid artery was trapped with proximal ligation and distal clipping at the supraclinoid segment.

Key Words: Giant aneurysm; Saphenous vein bypass graft; Hemorrhagic infarct