Endovascular stenting of an extracranial-intracranial saphenous vein high-flow bypass graft: Technical case report

BACKGROUND: The authors describe a case of endovascular stenting of an extracranial-intracranial saphenous vein high-flow bypass graft in the management of a complex bilateral carotid aneurysm case.

CASE DESCRIPTION: A 43-year-old woman was admitted with progressive visual field restriction and headache. Imaging studies revealed bilateral supraclinoid carotid aneurysms. The right carotid aneurysm was clipped and the left one was treated by an endovascular procedure, after performing an internal carotid artery-middle cerebral artery (ICA-MCA) saphenous vein bypass graft. A few months following the bypass procedure, a 70-80% stenosis of the graft was discovered and treated endovascularly with a stenting procedure. Follow-up at 36 months after the first operation showed the patency of the venous graft and no neurological deficits.

CONCLUSIONS: Endovascular stenting of the extracranial-intracranial saphenous vein high-flow bypass graft is technically feasible when postoperative graft occlusion is discovered.