Principles of Revascularization in Treatment of Large and Giant Cerebral Aneurysms

Over the past decades, the interest of neurosurgeons in extra-intracranial anastomoses has increased significantly, especially in the context of their use in the treatment of large and giant aneurysms. The development of microsurgical techniques and neuroanesthetic techniques, adequate selection of patients for surgery, achievements in neuroradiology and monitoring of cerebral blood flow are prerequisites for the improvement of revascularization surgery. The development of competitive endovascular methods of treatment, in turn, pushes neurosurgeons to improve the microneurosurgical technique of revascularization and develop new approaches to the treatment of intracranial aneurysms. In this review, we present the principles of cerebrovascular anastomosis surgery in the treatment of large and giant aneurysms used in our clinic.