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Sanai N et al. – IC–IC bypasses compare favorably to EC–IC bypasses in terms of aneurysm obliteration rates, bypass patency rates, and neurological outcomes. IC–IC bypasses can be more technically challenging to perform, but they do not require harvest of extracranial donor arteries, spare patients a neck incision, shorten interposition grafts, are protected inside the cranium, use caliber–matched donor and recipient arteries, and are not associated with ischemic complications during temporary arterial occlusions. IC–IC bypass can replace conventional EC–IC bypass with more anatomic reconstructions for selected aneurysms involving the middle cerebral artery, posteroinferior cerebellar artery, anterior cerebral artery, and basilar apex.

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