{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T13:34:24Z","timestamp":1781357664980,"version":"3.54.1"},"reference-count":54,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>For complex intracranial aneurysms (CIAs), extracranial-intracranial (EC-IC) bypass with immediate parent artery (PA) occlusion is an accepted strategy but is associated with a high postoperative infarction rate. This study explores the efficacy of a novel staged therapy, characterized by a first-stage EC-IC bypass followed by second-stage PA occlusion, with a focus on aneurysm change and hemodynamic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Thirty-six patients with CIAs undergoing staged therapy from January 2018 to November 2022 were prospectively recruited. Hemodynamic analysis was performed using 4D flow MRI and computational fluid dynamics (CFD) based on CT angiography. Operation-related complications, postoperative hemodynamics, and aneurysm change were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Following first-stage bypass, aneurysms disappeared in 6 patients (16.7%), increased in size in 8 patients (22.2%), and remained unchanged in 22 patients (61.1%). Of the 16 cases (44.4%) available for 4D flow analysis, postoperative flow in the donor vessel increased gradually, peaking at 4.26 times the preoperative value by the 6th day after bypass, before subsequently decreasing. Hemodynamic patterns in the PA varied. In cases in which wall shear stress (WSS) and streamline velocity decreased (n = 4), 4D flow analysis revealed a decreasing trend in PA flow after the turning point, which corresponded with aneurysm resolution. Conversely, in cases with increased WSS and streamline velocity (n = 12), 4D flow analysis showed an increasing trend in PA flow after the turning point, corresponding with aneurysm enlargement or stability. Of 29 cases receiving second-stage PA occlusion, aneurysms disappeared in 27 patients (93.1%) and decreased in size in 2 patients (6.9%). Two patients developed ischemic events at 7 and 10 days postprocedure, respectively. At the latest follow-up, 91.7% (33\/36) of the cases showed aneurysm resolution, without the development of hemorrhagic events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Staged therapy appears to be a promising treatment for CIAs, yielding favorable outcomes. Hemodynamic evaluation is instrumental in assessing aneurysm changes after bypass and may help determine the optimal timing for second-stage treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.9.focus24761","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T13:24:55Z","timestamp":1764595495000},"page":"E12","source":"Crossref","is-referenced-by-count":1,"title":["A novel staged parent artery occlusion following extracranial-intracranial bypass for giant intracranial aneurysms: case series and hemodynamic insights via 4D flow MRI"],"prefix":"10.3171","volume":"59","author":[{"given":"Zhiyong","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun City, Jilin Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongbo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunhua","family":"Hang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binbin","family":"Sui","sequence":"additional","affiliation":[{"name":"Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Neurol India","first-page":"138","article-title":"Treatment of giant intracranial aneurysms: what is the best option?","volume":"63","author":"Misra BK","year":"2015","unstructured":"Misra BKTreatment of giant intracranial aneurysms: what is the best option?. Neurol India. 2015;63(2):138\u2013141."},{"key":"b2","series-title":"J Clin Neurosci","first-page":"132","article-title":"Microsurgical outcome of unruptured giant intracranial aneurysms: a single-center experience","volume":"70","author":"Li M","year":"2019","unstructured":"Li M, Ma Y, Jiang P, Wu J, Cao Y, Wang SMicrosurgical outcome of unruptured giant intracranial aneurysms: a single-center experience. J Clin Neurosci. 2019;70:132\u2013135."},{"issue":"4","key":"b3","series-title":"Article in Russian. Zh Vopr Neirokhir Im N N Burdenko","first-page":"19","article-title":"Endovascular treatment of large and giant intracranial aneurysms using flow-diverting stents","volume":"79","author":"Yakovlev SB","year":"2015","unstructured":"Yakovlev SB, Arustamyan SR, Dorokhov PS,  Endovascular treatment of large and giant intracranial aneurysms using flow-diverting stents. Article in Russian. Zh Vopr Neirokhir Im N N Burdenko. 2015;79(4):19\u201327."},{"issue":"suppl 7","key":"b4","series-title":"Surg Neurol Int","first-page":"S284","article-title":"Techniques in distal access of wide-necked giant intracranial aneurysms during treatment with flow diversion","volume":"6","author":"Kan P","year":"2015","unstructured":"Kan P, Wakhloo AK, Mokin M, Puri ATechniques in distal access of wide-necked giant intracranial aneurysms during treatment with flow diversion. Surg Neurol Int. 2015;6(suppl 7):S284\u2013S288."},{"issue":"5","key":"b5","series-title":"World Neurosurg","first-page":"696","article-title":"Treatment of large and giant intracranial aneurysms: cost comparison of flow diversion and traditional embolization strategies","volume":"82","author":"el-Chalouhi N","year":"2014","unstructured":"el-Chalouhi N, Jabbour PM, Tjoumakaris SI,  Treatment of large and giant intracranial aneurysms: cost comparison of flow diversion and traditional embolization strategies. World Neurosurg. 2014;82(5):696\u2013701."},{"issue":"4","key":"b6","series-title":"J Neurosurg","first-page":"1297","article-title":"Cerebral revascularization for the management of complex intracranial aneurysms: a single-center experience","volume":"131","author":"Nussbaum ES","year":"2019","unstructured":"Nussbaum ES, Kallmes KM, Lassig JP, Goddard JK, Madison MT, Nussbaum LACerebral revascularization for the management of complex intracranial aneurysms: a single-center experience. J Neurosurg. 2019;131(4):1297\u20131307."},{"issue":"1","key":"b7","series-title":"J Neurosurg","first-page":"57","article-title":"Management of giant intracranial ICA aneurysms with combined extracranial-intracranial anastomosis and endovascular occlusion","volume":"73","author":"Serbinenko FA","year":"1990","unstructured":"Serbinenko FA, Filatov JM, Spallone A, Tchurilov MV, Lazarev VAManagement of giant intracranial ICA aneurysms with combined extracranial-intracranial anastomosis and endovascular occlusion. J Neurosurg. 1990;73(1):57\u201363."},{"key":"b8","first-page":"e119","article-title":"Surgical management of giant intracranial aneurysms: overall results of a large series","volume":"144","author":"Luzzi S","year":"2020","unstructured":"Luzzi S, Gragnaniello C, Giotta Lucifero A, Del Maestro M, Galzio RSurgical management of giant intracranial aneurysms: overall results of a large series. World Neurosurg.2020;144:e119\u2013e137."},{"issue":"6","key":"b9","series-title":"World Neurosurg","first-page":"912","article-title":"Rescue bypass for revascularization after ischemic complications in the treatment of giant or complex intracranial aneurysms","volume":"83","author":"Pancucci G","year":"2015","unstructured":"Pancucci G, Potts MB, Rodr\u00edguez-Hern\u00e1ndez A, Andrade H, Guo L, Lawton MTRescue bypass for revascularization after ischemic complications in the treatment of giant or complex intracranial aneurysms. World Neurosurg. 2015;83(6):912\u2013920."},{"issue":"1","key":"b10","series-title":"Neurosurgery","first-page":"216","article-title":"Spontaneous occlusion of supraclinoid aneurysms after the creation of extra-intracranial bypasses using long grafts: report of two cases","volume":"44","author":"Cantore G","year":"1999","unstructured":"Cantore G, Santoro A, Da Pian RSpontaneous occlusion of supraclinoid aneurysms after the creation of extra-intracranial bypasses using long grafts: report of two cases. Neurosurgery. 1999;44(1):216\u2013220."},{"issue":"3","key":"b11","series-title":"J Neurosurg","first-page":"469","article-title":"Spontaneous thrombosis of a giant fusiform aneurysm following extracranial-intracranial bypass surgery","volume":"110","author":"Haque R","year":"2009","unstructured":"Haque R, Kellner C, Solomon RASpontaneous thrombosis of a giant fusiform aneurysm following extracranial-intracranial bypass surgery. J Neurosurg. 2009;110(3):469\u2013474."},{"key":"b12","first-page":"161","article-title":"Spontaneous thrombosis of giant dissecting fusiform middle cerebral aneurysm after double-barrel superficial temporal artery-middle cerebral artery bypass: a case report of decision-making in a limited resource environment","volume":"136","author":"Huynh TD","year":"2020","unstructured":"Huynh TD, Felbaum DR, Jean WC, Ngo HMSpontaneous thrombosis of giant dissecting fusiform middle cerebral aneurysm after double-barrel superficial temporal artery-middle cerebral artery bypass: a case report of decision-making in a limited resource environment. World Neurosurg.2020;136:161\u2013168."},{"issue":"1","key":"b13","series-title":"PLoS One","first-page":"e0188323","article-title":"Hemodynamics in a giant intracranial aneurysm characterized by in vitro 4D flow MRI","volume":"13","author":"Amili O","year":"2018","unstructured":"Amili O, Schiavazzi D, Moen S, Jagadeesan B, Van de Moortele PF, Coletti FHemodynamics in a giant intracranial aneurysm characterized by in vitro 4D flow MRI. PLoS One. 2018;13(1):e0188323."},{"issue":"1","key":"b14","series-title":"Acta Radiol","first-page":"105","article-title":"Endovascular embolization is applicable for large and giant intracranial aneurysms: experience in one center with long-term angiographic follow-up","volume":"56","author":"Wang B","year":"2015","unstructured":"Wang B, Gao BL, Xu GP, Xiang C, Liu XSEndovascular embolization is applicable for large and giant intracranial aneurysms: experience in one center with long-term angiographic follow-up. Acta Radiol. 2015;56(1):105\u2013113."},{"issue":"1","key":"b15","series-title":"J Neurosurg","first-page":"40","article-title":"Use of detachable balloons for proximal artery occlusion in the treatment of unclippable cerebral aneurysms","volume":"66","author":"Fox AJ","year":"1987","unstructured":"Fox AJ, Vi\u00f1uela F, Pelz DM,  Use of detachable balloons for proximal artery occlusion in the treatment of unclippable cerebral aneurysms. J Neurosurg. 1987;66(1):40\u201346."},{"key":"b16","first-page":"568","article-title":"Internal maxillary artery bypass with radial artery graft treatment of giant intracranial aneurysms","volume":"105","author":"Wang L","year":"2017","unstructured":"Wang L, Lu S, Qian H, Xe SInternal maxillary artery bypass with radial artery graft treatment of giant intracranial aneurysms. World Neurosurg.2017;105:568\u2013584."},{"issue":"5","key":"b17","series-title":"Surg Neurol","first-page":"473","article-title":"Obliteration of a giant carotid aneurysm after extracranial-to-intracranial bypass surgery: case report","volume":"48","author":"Yeh H","year":"1997","unstructured":"Yeh H, Tomsick TAObliteration of a giant carotid aneurysm after extracranial-to-intracranial bypass surgery: case report. Surg Neurol. 1997;48(5):473\u2013476."},{"issue":"5","key":"b18","series-title":"Neurosurgery","first-page":"909","article-title":"Cross-comparison of 4-dimensional flow magnetic resonance imaging and intraoperative middle cerebral artery pressure measurements before and after superficial temporal artery-middle cerebral artery bypass surgery","volume":"89","author":"Sekine T","year":"2021","unstructured":"Sekine T, Murai Y, Orita E,  Cross-comparison of 4-dimensional flow magnetic resonance imaging and intraoperative middle cerebral artery pressure measurements before and after superficial temporal artery-middle cerebral artery bypass surgery. Neurosurgery. 2021;89(5):909\u2013916."},{"issue":"9","key":"b19","series-title":"AJNR Am J Neuroradiol","first-page":"1704","article-title":"Cerebral hemodynamics on MR perfusion images before and after bypass surgery in patients with giant intracranial aneurysms","volume":"22","author":"Caramia F","year":"2001","unstructured":"Caramia F, Santoro A, Pantano P,  Cerebral hemodynamics on MR perfusion images before and after bypass surgery in patients with giant intracranial aneurysms. AJNR Am J Neuroradiol. 2001;22(9):1704\u20131710."},{"key":"b20","series-title":"Acta Neurochir Suppl","first-page":"57","article-title":"Bypass surgeries in the treatment of cerebral aneurysms","volume":"123","author":"Hara T","year":"2016","unstructured":"Hara T, Arai S, Goto Y, Takizawa T, Uchida TBypass surgeries in the treatment of cerebral aneurysms. Acta Neurochir Suppl. 2016;123:57\u201364."},{"issue":"2","key":"b21","series-title":"Exp Ther Med","first-page":"883","article-title":"Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series","volume":"22","author":"Lu X","year":"2021","unstructured":"Lu X, Huang Y, Zhou P, Zhu W, Wang Z, Chen GCerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series. Exp Ther Med. 2021;22(2):883."},{"key":"b22","series-title":"Acta Neurochir Suppl","first-page":"25","article-title":"Giant and very large intracranial aneurysms: surgical strategies and special issues","volume":"129","author":"Luzzi S","year":"2018","unstructured":"Luzzi S, Gallieni M, Del Maestro M, Trovarelli D, Ricci A, Galzio RGiant and very large intracranial aneurysms: surgical strategies and special issues. Acta Neurochir Suppl. 2018;129:25\u201331."},{"issue":"1-2","key":"b23","series-title":"World Neurosurg","first-page":"130","article-title":"Universal extracranial-intracranial graft bypass for large or giant internal carotid aneurysms: techniques and results in 38 consecutive patients","volume":"82","author":"Ishishita Y","year":"2014","unstructured":"Ishishita Y, Tanikawa R, Noda K,  Universal extracranial-intracranial graft bypass for large or giant internal carotid aneurysms: techniques and results in 38 consecutive patients. World Neurosurg. 2014;82(1-2):130\u2013139."},{"issue":"3","key":"b24","series-title":"Neurosurg Clin N Am","first-page":"369","article-title":"Intracranial endovascular balloon test occlusion-indications, methods, and predictive value","volume":"20","author":"Chaudhary N","year":"2009","unstructured":"Chaudhary N, Gemmete JJ, Thompson BG, Pandey ASIntracranial endovascular balloon test occlusion-indications, methods, and predictive value. Neurosurg Clin N Am. 2009;20(3):369\u2013375."},{"issue":"2","key":"b25","series-title":"Neurosurg","first-page":"360","article-title":"Thrombosis of a giant aneurysm after extracranial-intracranial bypass","volume":"31","author":"Benashvili GM","year":"1992","unstructured":"Benashvili GM, Alexander LF, Zubkov YNThrombosis of a giant aneurysm after extracranial-intracranial bypass. Neurosurg. 1992;31(2):360\u2013364."},{"issue":"3","key":"b26","series-title":"Oper Neurosurg","first-page":"E110","article-title":"Two-stage revascularization and clip reconstruction of a giant ophthalmic artery aneurysm: 3-dimensional operative video","volume":"17","author":"Gandhi S","year":"2019","unstructured":"Gandhi S, Mascitelli JR, Zhao X,  Two-stage revascularization and clip reconstruction of a giant ophthalmic artery aneurysm: 3-dimensional operative video. Oper Neurosurg. 2019;17(3):E110\u2013E111."},{"issue":"2","key":"b27","series-title":"AJNR Am J Neuroradiol","first-page":"346","article-title":"Thrombosis heralding aneurysmal rupture: an exploration of potential mechanisms in a novel giant swine aneurysm model","volume":"34","author":"Raymond J","year":"2013","unstructured":"Raymond J, Darsaut TE, Kotowski M,  Thrombosis heralding aneurysmal rupture: an exploration of potential mechanisms in a novel giant swine aneurysm model. AJNR Am J Neuroradiol. 2013;34(2):346\u2013353."},{"issue":"2","key":"b1","series-title":"Neurol India","first-page":"138","article-title":"Treatment of giant intracranial aneurysms: what is the best option?","volume":"63","author":"Misra BK","year":"2015","unstructured":"Misra BKTreatment of giant intracranial aneurysms: what is the best option?. Neurol India. 2015;63(2):138\u2013141."},{"key":"b2","series-title":"J Clin Neurosci","first-page":"132","article-title":"Microsurgical outcome of unruptured giant intracranial aneurysms: a single-center experience","volume":"70","author":"Li M","year":"2019","unstructured":"Li M, Ma Y, Jiang P, Wu J, Cao Y, Wang SMicrosurgical outcome of unruptured giant intracranial aneurysms: a single-center experience. J Clin Neurosci. 2019;70:132\u2013135."},{"issue":"4","key":"b3","series-title":"Article in Russian. Zh Vopr Neirokhir Im N N Burdenko","first-page":"19","article-title":"Endovascular treatment of large and giant intracranial aneurysms using flow-diverting stents","volume":"79","author":"Yakovlev SB","year":"2015","unstructured":"Yakovlev SB, Arustamyan SR, Dorokhov PS,  Endovascular treatment of large and giant intracranial aneurysms using flow-diverting stents. Article in Russian. Zh Vopr Neirokhir Im N N Burdenko. 2015;79(4):19\u201327."},{"issue":"suppl 7","key":"b4","series-title":"Surg Neurol Int","first-page":"S284","article-title":"Techniques in distal access of wide-necked giant intracranial aneurysms during treatment with flow diversion","volume":"6","author":"Kan P","year":"2015","unstructured":"Kan P, Wakhloo AK, Mokin M, Puri ATechniques in distal access of wide-necked giant intracranial aneurysms during treatment with flow diversion. Surg Neurol Int. 2015;6(suppl 7):S284\u2013S288."},{"issue":"5","key":"b5","series-title":"World Neurosurg","first-page":"696","article-title":"Treatment of large and giant intracranial aneurysms: cost comparison of flow diversion and traditional embolization strategies","volume":"82","author":"el-Chalouhi N","year":"2014","unstructured":"el-Chalouhi N, Jabbour PM, Tjoumakaris SI,  Treatment of large and giant intracranial aneurysms: cost comparison of flow diversion and traditional embolization strategies. World Neurosurg. 2014;82(5):696\u2013701."},{"issue":"4","key":"b6","series-title":"J Neurosurg","first-page":"1297","article-title":"Cerebral revascularization for the management of complex intracranial aneurysms: a single-center experience","volume":"131","author":"Nussbaum ES","year":"2019","unstructured":"Nussbaum ES, Kallmes KM, Lassig JP, Goddard JK, Madison MT, Nussbaum LACerebral revascularization for the management of complex intracranial aneurysms: a single-center experience. J Neurosurg. 2019;131(4):1297\u20131307."},{"issue":"1","key":"b7","series-title":"J Neurosurg","first-page":"57","article-title":"Management of giant intracranial ICA aneurysms with combined extracranial-intracranial anastomosis and endovascular occlusion","volume":"73","author":"Serbinenko FA","year":"1990","unstructured":"Serbinenko FA, Filatov JM, Spallone A, Tchurilov MV, Lazarev VAManagement of giant intracranial ICA aneurysms with combined extracranial-intracranial anastomosis and endovascular occlusion. J Neurosurg. 1990;73(1):57\u201363."},{"key":"b8","first-page":"e119","article-title":"Surgical management of giant intracranial aneurysms: overall results of a large series","volume":"144","author":"Luzzi S","year":"2020","unstructured":"Luzzi S, Gragnaniello C, Giotta Lucifero A, Del Maestro M, Galzio RSurgical management of giant intracranial aneurysms: overall results of a large series. World Neurosurg.2020;144:e119\u2013e137."},{"issue":"6","key":"b9","series-title":"World Neurosurg","first-page":"912","article-title":"Rescue bypass for revascularization after ischemic complications in the treatment of giant or complex intracranial aneurysms","volume":"83","author":"Pancucci G","year":"2015","unstructured":"Pancucci G, Potts MB, Rodr\u00edguez-Hern\u00e1ndez A, Andrade H, Guo L, Lawton MTRescue bypass for revascularization after ischemic complications in the treatment of giant or complex intracranial aneurysms. World Neurosurg. 2015;83(6):912\u2013920."},{"issue":"1","key":"b10","series-title":"Neurosurgery","first-page":"216","article-title":"Spontaneous occlusion of supraclinoid aneurysms after the creation of extra-intracranial bypasses using long grafts: report of two cases","volume":"44","author":"Cantore G","year":"1999","unstructured":"Cantore G, Santoro A, Da Pian RSpontaneous occlusion of supraclinoid aneurysms after the creation of extra-intracranial bypasses using long grafts: report of two cases. Neurosurgery. 1999;44(1):216\u2013220."},{"issue":"3","key":"b11","series-title":"J Neurosurg","first-page":"469","article-title":"Spontaneous thrombosis of a giant fusiform aneurysm following extracranial-intracranial bypass surgery","volume":"110","author":"Haque R","year":"2009","unstructured":"Haque R, Kellner C, Solomon RASpontaneous thrombosis of a giant fusiform aneurysm following extracranial-intracranial bypass surgery. J Neurosurg. 2009;110(3):469\u2013474."},{"key":"b12","first-page":"161","article-title":"Spontaneous thrombosis of giant dissecting fusiform middle cerebral aneurysm after double-barrel superficial temporal artery-middle cerebral artery bypass: a case report of decision-making in a limited resource environment","volume":"136","author":"Huynh TD","year":"2020","unstructured":"Huynh TD, Felbaum DR, Jean WC, Ngo HMSpontaneous thrombosis of giant dissecting fusiform middle cerebral aneurysm after double-barrel superficial temporal artery-middle cerebral artery bypass: a case report of decision-making in a limited resource environment. World Neurosurg.2020;136:161\u2013168."},{"issue":"1","key":"b13","series-title":"PLoS One","first-page":"e0188323","article-title":"Hemodynamics in a giant intracranial aneurysm characterized by in vitro 4D flow MRI","volume":"13","author":"Amili O","year":"2018","unstructured":"Amili O, Schiavazzi D, Moen S, Jagadeesan B, Van de Moortele PF, Coletti FHemodynamics in a giant intracranial aneurysm characterized by in vitro 4D flow MRI. PLoS One. 2018;13(1):e0188323."},{"issue":"1","key":"b14","series-title":"Acta Radiol","first-page":"105","article-title":"Endovascular embolization is applicable for large and giant intracranial aneurysms: experience in one center with long-term angiographic follow-up","volume":"56","author":"Wang B","year":"2015","unstructured":"Wang B, Gao BL, Xu GP, Xiang C, Liu XSEndovascular embolization is applicable for large and giant intracranial aneurysms: experience in one center with long-term angiographic follow-up. Acta Radiol. 2015;56(1):105\u2013113."},{"issue":"1","key":"b15","series-title":"J Neurosurg","first-page":"40","article-title":"Use of detachable balloons for proximal artery occlusion in the treatment of unclippable cerebral aneurysms","volume":"66","author":"Fox AJ","year":"1987","unstructured":"Fox AJ, Vi\u00f1uela F, Pelz DM,  Use of detachable balloons for proximal artery occlusion in the treatment of unclippable cerebral aneurysms. J Neurosurg. 1987;66(1):40\u201346."},{"key":"b16","first-page":"568","article-title":"Internal maxillary artery bypass with radial artery graft treatment of giant intracranial aneurysms","volume":"105","author":"Wang L","year":"2017","unstructured":"Wang L, Lu S, Qian H, Xe SInternal maxillary artery bypass with radial artery graft treatment of giant intracranial aneurysms. World Neurosurg.2017;105:568\u2013584."},{"issue":"5","key":"b17","series-title":"Surg Neurol","first-page":"473","article-title":"Obliteration of a giant carotid aneurysm after extracranial-to-intracranial bypass surgery: case report","volume":"48","author":"Yeh H","year":"1997","unstructured":"Yeh H, Tomsick TAObliteration of a giant carotid aneurysm after extracranial-to-intracranial bypass surgery: case report. Surg Neurol. 1997;48(5):473\u2013476."},{"issue":"5","key":"b18","series-title":"Neurosurgery","first-page":"909","article-title":"Cross-comparison of 4-dimensional flow magnetic resonance imaging and intraoperative middle cerebral artery pressure measurements before and after superficial temporal artery-middle cerebral artery bypass surgery","volume":"89","author":"Sekine T","year":"2021","unstructured":"Sekine T, Murai Y, Orita E,  Cross-comparison of 4-dimensional flow magnetic resonance imaging and intraoperative middle cerebral artery pressure measurements before and after superficial temporal artery-middle cerebral artery bypass surgery. Neurosurgery. 2021;89(5):909\u2013916."},{"issue":"9","key":"b19","series-title":"AJNR Am J Neuroradiol","first-page":"1704","article-title":"Cerebral hemodynamics on MR perfusion images before and after bypass surgery in patients with giant intracranial aneurysms","volume":"22","author":"Caramia F","year":"2001","unstructured":"Caramia F, Santoro A, Pantano P,  Cerebral hemodynamics on MR perfusion images before and after bypass surgery in patients with giant intracranial aneurysms. AJNR Am J Neuroradiol. 2001;22(9):1704\u20131710."},{"key":"b20","series-title":"Acta Neurochir Suppl","first-page":"57","article-title":"Bypass surgeries in the treatment of cerebral aneurysms","volume":"123","author":"Hara T","year":"2016","unstructured":"Hara T, Arai S, Goto Y, Takizawa T, Uchida TBypass surgeries in the treatment of cerebral aneurysms. Acta Neurochir Suppl. 2016;123:57\u201364."},{"issue":"2","key":"b21","series-title":"Exp Ther Med","first-page":"883","article-title":"Cerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series","volume":"22","author":"Lu X","year":"2021","unstructured":"Lu X, Huang Y, Zhou P, Zhu W, Wang Z, Chen GCerebral revascularization for the management of complex middle cerebral artery aneurysm: A case series. Exp Ther Med. 2021;22(2):883."},{"key":"b22","series-title":"Acta Neurochir Suppl","first-page":"25","article-title":"Giant and very large intracranial aneurysms: surgical strategies and special issues","volume":"129","author":"Luzzi S","year":"2018","unstructured":"Luzzi S, Gallieni M, Del Maestro M, Trovarelli D, Ricci A, Galzio RGiant and very large intracranial aneurysms: surgical strategies and special issues. Acta Neurochir Suppl. 2018;129:25\u201331."},{"issue":"1-2","key":"b23","series-title":"World Neurosurg","first-page":"130","article-title":"Universal extracranial-intracranial graft bypass for large or giant internal carotid aneurysms: techniques and results in 38 consecutive patients","volume":"82","author":"Ishishita Y","year":"2014","unstructured":"Ishishita Y, Tanikawa R, Noda K,  Universal extracranial-intracranial graft bypass for large or giant internal carotid aneurysms: techniques and results in 38 consecutive patients. World Neurosurg. 2014;82(1-2):130\u2013139."},{"issue":"3","key":"b24","series-title":"Neurosurg Clin N Am","first-page":"369","article-title":"Intracranial endovascular balloon test occlusion-indications, methods, and predictive value","volume":"20","author":"Chaudhary N","year":"2009","unstructured":"Chaudhary N, Gemmete JJ, Thompson BG, Pandey ASIntracranial endovascular balloon test occlusion-indications, methods, and predictive value. Neurosurg Clin N Am. 2009;20(3):369\u2013375."},{"issue":"2","key":"b25","series-title":"Neurosurg","first-page":"360","article-title":"Thrombosis of a giant aneurysm after extracranial-intracranial bypass","volume":"31","author":"Benashvili GM","year":"1992","unstructured":"Benashvili GM, Alexander LF, Zubkov YNThrombosis of a giant aneurysm after extracranial-intracranial bypass. Neurosurg. 1992;31(2):360\u2013364."},{"issue":"3","key":"b26","series-title":"Oper Neurosurg","first-page":"E110","article-title":"Two-stage revascularization and clip reconstruction of a giant ophthalmic artery aneurysm: 3-dimensional operative video","volume":"17","author":"Gandhi S","year":"2019","unstructured":"Gandhi S, Mascitelli JR, Zhao X,  Two-stage revascularization and clip reconstruction of a giant ophthalmic artery aneurysm: 3-dimensional operative video. 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