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Left middle cerebral artery M1-2 segment dissecting aneurysm resection and reanastomosis under double-barrel STA-MCA bypass protection

  • How I Do it - Vascular Neurosurgery - Aneurysm
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Abstract

Background

Middle cerebral artery (MCA) M1-related dissecting aneurysms involving the M1 segment are difficult because of the involvement of M1 perforators and the short duration of ischemia tolerance during bypass.

Method

We report a case of MCA M1-2 dissecting aneurysm resection and reanastomosis under bypass blood flow protection. Histological staining was used to show aneurysm pathological characteristics.

Conclusion

This case demonstrates the value of distal bypass for blood flow protection in MCA M1-2 dissecting aneurysm dissection and reanastomosis. Pathological staining showed intramural thrombus, cell dysfunction, microtube formation, and obvious inflammation.

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Acknowledgements

The authors thank Qiang Xu and Yingtao Liu for the imaging processing and Geng Xu for the intraoperative electrophysiological monitoring support.

Funding

This study was supported by the Outstanding Academic Leaders Program of Shanghai Municipal Commission of Health and Family Planning (No. 2017BR006 to WZ), Clinical Research Plan of SHDC (No. SHDC2020CR2034B to WZ), Shanghai Municipal Science and Technology Major Project (No. 2018SHZDZX01) and ZJ Lab, and CAMS Innovation Fund for Medical Sciences (CIFMS, 2019-I2 M-5–008).

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Author notes

  1. Peixi Liu and Yuan Shi contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No.12 Wulumuqi Zhong Road, Shanghai, 200040, China

    Peixi Liu, Yuan Shi, Qingzhu An & Wei Zhu

  2. National Center for Neurological Disorders, Shanghai, China

    Peixi Liu, Yuan Shi, Qingzhu An & Wei Zhu

  3. Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China

    Peixi Liu, Yuan Shi, Qingzhu An & Wei Zhu

  4. Neurosurgical Institute of Fudan University, Shanghai, China

    Peixi Liu, Yuan Shi, Qingzhu An & Wei Zhu

  5. Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China

    Peixi Liu, Yuan Shi, Qingzhu An & Wei Zhu

Authors
  1. Peixi Liu
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  2. Yuan Shi
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  3. Qingzhu An
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  4. Wei Zhu
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Corresponding author

Correspondence to Wei Zhu.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Huashan Hospital Institutional Review Board (HIRB), Fudan University, Shanghai, China.

Consent to participate

It represents a video of a surgical case. The patient gave approval for publication of this case.

Conflict of interest

The authors declare no competing interests.

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This article is part of the Topical Collection on Vascular Neurosurgery - Aneurysm

Supplementary Information

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Supplementary file1 Video Legends. This video illustrates a left middle cerebral artery M1-2 segment dissecting aneurysm resection and reanastomosis under double-barrel STA-MCA bypass protection. (MP4 90327 KB)

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Liu, P., Shi, Y., An, Q. et al. Left middle cerebral artery M1-2 segment dissecting aneurysm resection and reanastomosis under double-barrel STA-MCA bypass protection. Acta Neurochir 164, 3209–3213 (2022). https://doi.org/10.1007/s00701-022-05386-5

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  • DOI: https://doi.org/10.1007/s00701-022-05386-5

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