Comparison of Graft Patency Between STA, RA, and SV Grafts of Intracranial Aneurysms of the Internal Carotid Artery

Background: Patients with intracranial internal carotid artery (ICA) aneurysms that are not amenable to treatments like coiling, stenting, or clipping have limited treatment options. One option is vascular bypass of the aneurysm to introduce a stable route for cerebral perfusion, which can be performed using the superficial temporal artery (STA) or alternatively radial artery (RA) or saphenous vein (SV) grafts, among other vessels. Methods: The major databases were searched to identify studies that explored graft patency and functional outcome for patients who underwent bypass for intracranial ICA aneurysms with STA, RA, or SV grafts and proportion meta-analysis was performed. Results: Screening yielded a total of eight publications that met our inclusion criteria. Grafts of the STA were patent in 76 out of 80 patients (95.0%) in the perioperative period, while 47 out of 47 (100%) RA grafts and 37 out of 38 (97.3%) SV grafts were patent. Good functional outcome (mRS 0-2 or GOS 4-5) was seen in 88.3% (68 of 77) of STA grafts, 96.6% (28 of 29) of RA grafts, and 89.5% (34 of 38) SV donors. Conclusions: This review highlights the good patency rates of STA, RA, and SVG graft types in patients that are suitable candidates for their respective interventions. Statistical analysis did not indicate a preferred donor vessel if for cases where all options are viable.