| Automated end-to-side anastomosis to the middle cerebral artery: a feasibility study. | |
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MedLine Citation:
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PMID: 18312105 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Amadé Bregy; Alex Alfieri; Stefanos Demertzis; Pasquale Mordasini; Anna Katharina Jetzer; Dominique Kuhlen; Thomas Schaffner; Ralph Dacey; Hans-Jakob Steiger; Michael Reinert |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of neurosurgery Volume: 108 ISSN: 0022-3085 ISO Abbreviation: J. Neurosurg. Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-03-03 Completed Date: 2008-04-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: United States |
Other Details:
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Languages: eng Pagination: 567-74 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurosurgery, Inselspital Bern, University of Bern, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical
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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
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