Surgical treatment of a patient with saccular arterial aneurysm of the cavernous-ophthalmic segment

Shabaev A.R.^1,2, Kazantsev A.N.^1,2, Tarasov R.S.², Ruban E.V.¹, Lider R.Yu.³, Yakhnis E.Ya.³, Solobuev A.I.³, Volkov A.N.¹, Mironov A.V.^1,2

1) Kemerovo Regional Clinical Cardiological Dispensary named after Academician L.S. Barbarash,
2) Research Institute for Complex Problems of Cardiovascular Diseases,
3) Kemerovo State Medical University of the RF Ministry of Public Health, Kemerovo, Russia

Presented in the article are the results of surgical management of a patient with an extremely rare pathology – a saccular arterial aneurysm of the cavernous-ophthalmic segment of the left internal carotid artery. We performed multistage open surgical intervention in the following scope: osteoplastic pterional craniotomy on the left, creation of a wide-lumen anastomosis between the left external carotid artery and M2 segment of the left middle cerebral artery with the use of the radial artery, ligation of the cervical portion of the left internal carotid artery and clipping of its supraclinoid portion. The chosen surgical policy made it possible to create sufficient volumetric blood flow through the shunt, comparable to the blood flow through the internal carotid artery, which helped avoid ischaemic stroke after exclusion of the aneurysm from circulation. A conclusion was drawn on efficacy of this method of treatment.

KEY WORDS: saccular arterial aneurysm of the cavernous-ophthalmic segment, giant aneurysm, wide-lumen anastomosis, microsurgical treatment.

P. 138

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