Reconstruction of both M2 blood flow with a "Y" fashion anastomosis after excision of a large M1 bifurcation aneurysm: advantages and challenges.

BACKGROUND

Middle cerebral artery (MCA) M1 aneurysms with M2 branches originating from the aneurysm neck are difficult to treat because of blood flow reconstruction method selection, graft blood volume matching and various anastomoses.

METHOD: We report a case of MCA M1 bifurcation aneurysm resection and reconstruction of the bifurcation using "Y" fashion anastomosis. Intraoperative DSA showed anastomotic stoma patency. This patient suffered transient left temporal ischemia and recovered well with a modified Rankin scale of 0 at discharge.

CONCLUSION

This case demonstrates the application of "Y" fashion anastomosis after the excision of a large M1 bifurcation aneurysm. This bifurcation reconstruction method showed advantages and challenges in specific situations.