{"id":"c182b428-1a5e-4e61-944b-66be94f781d4","slug":"a-short-segment-intracranial-intracranial-jump-graft-bypass-followed-by-proximal-arterial-occlusion-for-a-distal-mca-aneurysm","title":"A short segment intracranial–intracranial jump graft bypass followed by proximal arterial occlusion for a distal MCA aneurysm","authors":["Leslie Nussbaum","Archie Defillo","Andrea Zelensky","Eric S. Nussbaum"],"abstract":"Background: Mycotic intracranial aneurysms are often associated with bacterial endocarditis and primarily affect the distal middle cerebral artery (MCA) branches, posing significant management challenges. These lesions can be difficult to locate and may not be amenable to primary reconstruction due to their friable nature. Vascular sacrifice is a potential treatment option but carries the risk of ischemic injury to the brain supplied by the affected segment. Methods: In this case, a 54-year-old woman with a presumed mycotic aneurysm underwent a short segment intracranial-intracranial jump graft bypass using the superficial temporal artery (STA). The procedure involved harvesting a segment of the STA and creating end-to-side anastomoses to both a normal cortical artery and a nearby cortical branch from the aneurysmal segment. Intraoperative angiography was used to confirm the patency of the jump graft before proceeding with endovascular sacrifice of the parent vessel. Results: The intraoperative angiogram demonstrated successful patency of the jump graft. Following the bypass, the patient underwent coil embolization of the parent MCA-M3 posterior division at the aneurysm site. Postoperatively, the patient remained neurologically stable and was discharged in good condition. Conclusion: The management of mycotic aneurysms is complex, and the combination of cortical IC–IC bypass followed by endovascular arterial sacrifice presents a safe and effective treatment option. This approach may be particularly beneficial in cases where vascular sacrifice is necessary but poses a risk of ischemic injury. Keywords: mycotic aneurysm, MCA, bypass, endovascular, surgery, ischemia, vascular reconstruction","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/c182b428-1a5e-4e61-944b-66be94f781d4/featured/hero-1782420839654.png","publishDate":"2011-07-18T00:00:00.000Z","doi":"10.4103/2152-7806.82991","categories":["Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2015/05/3426/SNI-2-98.pdf"}