{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:53:14Z","timestamp":1783774394572,"version":"3.55.0"},"reference-count":80,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The 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).<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n All IMA bypasses performed between January 2010 and July 2018 in a single-center, single-surgeon practice were screened.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n In total, 12 patients (9 males, 3 females) with CMCAAs managed by high-flow IMA bypass were identified. The mean size of CMCAAs was 23.7 mm (range 10\u201337 mm), and the patients had a mean age of 31.7 years (range 14\u201356 years). The aneurysms were proximally occluded in 8 cases, completely trapped in 3 cases, and completely resected in 1 case. The radial artery was used as the graft vessel in all cases. At discharge, the graft patency rate was 83.3% (n = 10), and all aneurysms were completely eliminated (83.3%, n = 10) or greatly diminished (16.7%, n = 2) from the circulation. Postoperative ischemia was detected in 2 patients as a result of graft occlusion, and 1 patient presenting with subarachnoid hemorrhage achieved improved modified Rankin Scale scores compared to the preoperative status but retained some neurological deficits. Therefore, neurological assessment at discharge showed that 9 of the 12 patients experienced unremarkable outcomes. The mean interval time from bypass to angiographic and clinical follow-up was 28.7 months (range 2\u201374 months) and 53.1 months (range 19\u201382 months), respectively. Although 2 grafts remained occluded, all aneurysms were isolated from the circulation, and no patient had an unfavorable outcome.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The satisfactory result in the present study demonstrated that IMA bypass is a promising method for the treatment of CMCAAs and should be maintained in the neurosurgical armamentarium. However, cases with intraoperative radical resection or inappropriate bypass recipient selection such as aneurysmal wall should be meticulously chosen with respect to the subtype of MCA aneurysm.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2018.11.focus18457","type":"journal-article","created":{"date-parts":[[2019,2,26]],"date-time":"2019-02-26T20:59:11Z","timestamp":1551214751000},"page":"E10","source":"Crossref","is-referenced-by-count":14,"title":["Internal maxillary artery bypass for the treatment of complex middle cerebral artery aneurysms"],"prefix":"10.3171","volume":"46","author":[{"given":"Long","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China;"},{"name":"Department of Neurosurgery, Stroke Center, Teishinkai Hospital, Sapporo, Japan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuaibin","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Shijingshan Hospital, Beijing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of University of South China, Hengyang, China;"},{"name":"Arkansas Neuroscience Institute, St. Vincent Hospital, Little Rock, Arkansas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rokuya","family":"Tanikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stroke Center, Teishinkai Hospital, Sapporo, Japan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang\u2019en","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China;"},{"name":"Department of Neurosurgery, Fuxing Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Oper Neurosurg (Hagerstown)","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1093\/ons\/opw010","article-title":"Internal maxillary artery to M2 middle cerebral artery bypass with modified superficial temporal artery graft: 3-dimensional operative video","volume":"13","author":"Benet A","year":"2017","unstructured":"Benet A, Meybodi AT, Feng X, Lawton MT: Internal maxillary artery to M2 middle cerebral artery bypass with modified superficial temporal artery graft: 3-dimensional operative video. 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