Vasospasm of venous grafts in extra-intracranial by-pass: Report of two cases

A. Santoro, M. Piccirilli, P. Ciappetta, G. Guidetti, G. Cantore

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Two patients are described, the first with a giant aneurysm of the left carotid bifurcation previously treated by endovascular technique, the second with a bilateral intracavernous aneurysm: both were submitted to highflow by-pass operation. The first patient was a 40 year-old woman who had presented subarachnoid hemorrhage 6 months before operation. She had been treated by means of a high-flow by-pass between the external carotid artery and the middle cerebral artery. Control angiograms performed 12 hours later showed a stenosis above the suture between the external carotid artery and the venous graft. Angioplasty was performed by endovascular route: new angiograms showed occlusion of the graft while dopplersonography demonstrated the presence of flow within the graft. Angiograms performed 1 week later showed marked vasospasm of the venous graft, of the internal carotid artery, the anterior cerebral artery and the middle cerebral artery. The evolution of spasm of the graft and of the intracranial arterial flow was monitored by dopplersonography and MR-angiography: the latter was performed 20 days after the last angiography and confirmed patency of the graft, while dopplersonography showed resolution of vasospasm. Finally, the aneurysm was embolized. The second patient was a 49 year-old woman with mild left palpebral ptosis and retro-orbital pain. She had already been submitted to high-flow by-pass operation 7 months earlier to treat a right intracavernous aneurysm; the left by-pass was necessary because the intracavernous aneurysm had become symptomatic. One week after surgery, spasm of the venous graft was documented by MR-angiography. In both cases, treatment consisted of calcium antagonists as well as hypertensive and hypervolemic medication, which was successful in treating vasospasm of the venous graft and its symptoms. Spasm of the venous graft, a well-known occurrence in cardiac revascularization, can also be observed in cerebral revascularization.

Original languageEnglish
Pages (from-to)107-115
Number of pages9
JournalJournal of Neurosurgical Sciences
Volume49
Issue number3
Publication statusPublished - Sep 2005

Fingerprint

Transplants
Angiography
Aneurysm
Spasm
External Carotid Artery
Middle Cerebral Artery
Cerebral Revascularization
Anterior Cerebral Artery
Endovascular Procedures
Internal Carotid Artery
Eyelids
Subarachnoid Hemorrhage
Angioplasty
Sutures
Pathologic Constriction
Calcium
Pain

Keywords

  • Aneurysms
  • Angiography
  • Magnetic resonance
  • Saphenous vein graft
  • Spasm

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Santoro, A., Piccirilli, M., Ciappetta, P., Guidetti, G., & Cantore, G. (2005). Vasospasm of venous grafts in extra-intracranial by-pass: Report of two cases. Journal of Neurosurgical Sciences, 49(3), 107-115.

Vasospasm of venous grafts in extra-intracranial by-pass : Report of two cases. / Santoro, A.; Piccirilli, M.; Ciappetta, P.; Guidetti, G.; Cantore, G.

In: Journal of Neurosurgical Sciences, Vol. 49, No. 3, 09.2005, p. 107-115.

Research output: Contribution to journalArticle

Santoro, A, Piccirilli, M, Ciappetta, P, Guidetti, G & Cantore, G 2005, 'Vasospasm of venous grafts in extra-intracranial by-pass: Report of two cases', Journal of Neurosurgical Sciences, vol. 49, no. 3, pp. 107-115.
Santoro A, Piccirilli M, Ciappetta P, Guidetti G, Cantore G. Vasospasm of venous grafts in extra-intracranial by-pass: Report of two cases. Journal of Neurosurgical Sciences. 2005 Sep;49(3):107-115.
Santoro, A. ; Piccirilli, M. ; Ciappetta, P. ; Guidetti, G. ; Cantore, G. / Vasospasm of venous grafts in extra-intracranial by-pass : Report of two cases. In: Journal of Neurosurgical Sciences. 2005 ; Vol. 49, No. 3. pp. 107-115.
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