Document Detail


Automated end-to-side anastomosis to the middle cerebral artery: a feasibility study.
MedLine Citation:
PMID:  18312105     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The treatment of complex cerebrovascular or skull base pathological conditions necessitates a microsurgical blood flow preservation or augmentative revascularization procedure as either an adjunctive safety measure or a definitive treatment. The brain is susceptible to ischemia, and procedure-related risks can be minimized by the reduction of occlusion time or the use of a nonocclusive technique. The authors therefore analyzed the feasibility of an automatic device (C-Port xA, Cardica) designed for constructing an end-to-side anastomosis with or without flow interruption for a middle cerebral artery (MCA) bypass in a human cadaveric model and in an in vivo craniotomy simulation model. METHODS: Four Thiel-fixated human head specimens were prepared using 8 standard pterional craniotomies. The sylvian fissure was opened to access the anterior circulation and in particular the MCA. The length of the individual vessel segments was measured. The C-Port xA was tested on each of the 8 exposures. In addition the C-Port xA was deployed in an in vivo craniotomy simulator model in 10 New Zealand rabbits (a total of 20 anastomoses) by using the abdominal aorta jump graft model. RESULTS: Short-term patency was assessed by angiography and histological findings. In all 8 sylvian exposures, construction of an MCA anastomosis with the aid of the C-Port xA was feasible. All 20 jump graft anastomoses performed in the in vivo craniotomy simulator were found to be patent. CONCLUSIONS: The anatomical studies as well as the in vivo craniotomy simulation studies demonstrated that the dimensions of the automated end-to-side anastomosis device are suitable for an extracranial-intracranial high-flow bypass on the MCA. Further miniaturization and special adaptation of this device would allow bypass procedures to more proximal intracranial vessels.
Authors:
Amadé Bregy; Alex Alfieri; Stefanos Demertzis; Pasquale Mordasini; Anna Katharina Jetzer; Dominique Kuhlen; Thomas Schaffner; Ralph Dacey; Hans-Jakob Steiger; Michael Reinert
Related Documents :
11061935 - Flow characteristics of 3 unique ureteral stents: investigation of a poiseuille flow pa...
3875615 - The response to papaverine in coronary artery bypass graft flows.
9313125 - Use of fibrin sealant in thermal injury.
12974455 - Longitudinal and seasonal variations of epilimnetic silica in a morphologically complex...
3810745 - Regional cerebral blood flow in essential hypertension: data evaluation by a mapping sy...
8599515 - Flow cytometric analysis of punctate and aggregate reticulocyte responses in phlebotomi...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  108     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-03     Completed Date:  2008-04-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  567-74     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Inselspital Bern, University of Bern, Switzerland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical / methods
Animals
Aorta, Abdominal
Cadaver
Cerebral Revascularization / instrumentation*,  methods
Craniotomy*
Disease Models, Animal
Feasibility Studies
Humans
Intracranial Aneurysm / surgery*
Microsurgery / instrumentation*
Middle Cerebral Artery / surgery*
Rabbits

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Association between semicarbazide-sensitive amine oxidase, a regulator of the glucose transporter, a...
Next Document:  Use of hemoglobin-based oxygen-carrying solution-201 to improve resuscitation parameters and prevent...