Internal maxillary artery bypass for the treatment of complex middle cerebral artery aneurysms.

OBJECTIVEThe rapid innovation of the endovascular armamentarium results in a decreased number of indications for a classic surgical approach. However, a middle cerebral artery (MCA) aneurysm remains the best example of one for which results have favored microsurgery over endovascular intervention. In this study, the authors aimed to evaluate the experience and efficacy regarding surgical outcomes after applying internal maxillary artery (IMA) bypass for complex MCA aneurysms (CMCAAs).

The History and Evolution of Internal Maxillary Artery Bypass.

Internal maxillary artery (IMA) bypass has gained momentum in the last 5 years for the treatment of complex cerebrovascular disorders and skull base tumors. However, some issues regarding this treatment modality have been proposed. As one of the most experienced neurosurgical teams to perform internal maxillary artery bypass in the world (>100 clinical cases), we reviewed the literature in aspects of basic anatomy of maxillary artery with its variations to the lateral pterygoid muscle, initial anastomosis modalities, and subsequent exposure techniques in cadaver studies, preoperative arterial evaluation methods, optimal interposed graft selections, and surgical outcome in the management of complex aneurysms, skull base tumors, and steno-occlusive disorders.

Internal Maxillary Artery Bypass with Radial Artery Graft Treatment of Giant Intracranial Aneurysms.

Background: Giant intracranial aneurysms (GIAs) can be approached via microsurgical and endovascular techniques. Use of flow diversion devices has yielded favorable outcomes, and indications for cerebral revascularization have dramatically decreased.

Objective: To evaluate the safety and validity of using internal maxillary artery (IMA) bypass with an interposed graft to treat GIAs.

Internal Maxillary Bypass for Complex Pediatric Aneurysms.

Background: Complex pediatric aneurysms (PAs) are an unusual clinicopathologic entity. Data regarding the use of a bypass procedure to treat complex PAs are limited.

Methods: Internal maxillary artery-to-middle cerebral artery bypass with radial artery graft was used to isolate PAs.

Outcome of Radical Surgical Resection for Craniopharyngioma with Hypothalamic Preservation: A Single-Center Retrospective Study of 1054 Patients.

Objective: A retrospective review of the surgical outcome for patients with craniopharyngioma (CP) treated in a single neurosurgical center with surgical resection using visualization to ensure hypothalamic preservation.

Methods: The study included 1054 patients. Before 2003, a pterional cranial approach was preferred for 78% of patients; after 2004, the unifrontal basal interhemispheric approach was performed in 79.