ArticleBrain sciences2022
The Role of Bypass Surgery for the Management of Complex Intracranial Aneurysms in the Anterior Circulation in the Flow-Diverter Era: A Single-Center Series.
Article in Brain sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- STA-MCA Double-Barrel Bypass: A Systematic Review of Technique and Single-Arm Meta-Analysis of Outcomes.Neurosurgical review · 2024Pooled it
- Acute and Chronic Cerebral Hypoperfusion After Flow-Diverter Placement: Is There a Role for Extra-Intracranial Bypass? A Case Series and Narrative Literature Review.Neurology international · 2026Article
- Double-barrel STA-MCA bypass with endovascular parent artery occlusion for complex anterior circulation aneurysms: indications and outcomes.Acta neurochirurgica · 2026Observational
- Angiosonography-guided bypass with parent vessel occlusion for the treatment of a complex fusiform MCA aneurysm: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Progressive thrombosis and involution of a pediatric giant middle cerebral artery pseudoaneurysm following superficial temporal artery-to-middle cerebral artery bypass: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Pseudoaneurysm development in extracranial-intracranial bypass surgery: Diagnostic challenges and surgical solutions.Surgical neurology international · 2025Review
- Flow Diversion for Cerebral Aneurysms: A Decade-Long Experience with Improved Outcomes and Predictors of Success.Brain sciences · 2024Article
- First-generation bypass surgery for a giant fusiform aneurysm of the middle cerebral artery: an illustrative case and surgical video.Journal of surgical case reports · 2024Article
- The surgical strategy and technical nuances ofFrontiers in neurology · 2023Article
- Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma Patients.Journal of clinical medicine · 2022Article
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Authors and funding
19 authors at 2 institutions in 1 country.
Funding
Abstract
Despite the increasing popularity of flow diverters (FDs) as an endovascular option for intracranial aneurysms, the treatment of complex aneurysms still represents a challenge. Combined strategies using a flow-preservation bypass could be considered in selected cases. In this study, we retrospectively reviewed our series of patients with complex intracranial aneurysms submitted to bypass. From January 2015 to May 2022, 23 patients were selected. We identified 11 cases (47.8%) of MCA, 6 cases (26.1%) of ACA and 6 cases (26.1%) of ICA aneurysms. The mean maximal diameter was 22.73 ± 12.16 mm, 8 were considered as giant, 9 were fusiform, 8 presented intraluminal thrombosis, 10 presented wall calcification, and 18 involved major branches or perforating arteries. Twenty-five bypass procedures were performed in 23 patients (two EC-IC bypasses with radial artery graft, seventeen single- or double-barrel STA-MCA bypasses and six IC-IC bypasses in anterior cerebral arteries). The long-term bypass patency rate was 94.5%, and the total aneurysm exclusion was 95.6%, with a mean follow-up of 28 months. Median KPS values at last follow-up was 90, and a favorable outcome (KPS ≥ 70 and mRS ≤ 2) was obtained in 87% of the cases. The use of bypass techniques represents, in selected cases, a valid therapeutic option in the management of complex anterior circulation aneurysms when a simpler direct approach, including the use of FD, is considered not feasible.
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