Complex surgery conducted successfully on 58-year-old woman at Apollo Hospital in Tirupati

Tirupati: A 58-year woman Chinnamma came to Apollo in January 2019 with history of headache, with ON & OFF vomiting. Patient was evaluated with MRI- Brain, she was found to have RT ICA Giant complex cavernous aneurysm.

She was advised to undergo surgery. Patient went to other hospital where she was operated and due to complex nature and the size of the aneurysm, Surgeon had abolished the procedure.

Patient came to us again in the month of August with the similar complaints along with diplopia (double vision). We evaluated her with CT Angiography and found the aneurysm was complex, giant. We discussed with our anesthesia team (Dr.Vamsi and team), C.T Surgeon (Dr.Nagaraju) and Interventional Nephrology (Dr. Gireesh Reddy), regarding feasibility of doing complex high flow bypass.

On 08-09-2019. We did balloon test occlusion of ICA, which patient tolerated well. We planned surgery on 09-09-2019 and she underwent RT M2MCA-RA-ECA high flow bypass with Clip ligation of cervical ICA.

Post-operatively patient electively ventilated for 2 days and then patient did well moving all 4limbs. Post-operative C T Angio showing, patent graft with complete re-vascularisation and diminution aneurysm size.Procedure done under Neuro monitoring Patient has recovered well.