Document Detail


Endoscopic radial artery harvesting for U-clip EC-IC bypass in the treatment of a giant petrous internal carotid artery aneurysm: technical case report.
MedLine Citation:
PMID:  19838973     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: High-flow extracranial-intracranial (EC-IC) bypass and aneurysm trapping constitutes a well-known surgical solution for internal carotid artery (ICA) aneurysms that are not amenable to clip ligation or endovascular therapy. The advantages of the radial artery (RA) as a conduit for myocardial revascularization have become widely accepted, with a better patency rate than that of the saphenous vein. CASE REPORT: A 66-year-old woman was found to harbour a right giant, partially thrombosed aneurysm of the intrapetrous segment of the internal carotid artery. Endoscopic harvesting of the RA was achieved combining a resterilizable retractor and a vessel sealing system. After neck dissection, the main trunk of the middle cerebral artery (MCA), its branches, and part of the aneurysm were isolated through a right fronto-orbito-zygomatic craniotomy. The external carotid artery, distal to the origin of the facial artery, was chosen in the neck for an end-to-end microanastomosis. The temporal branch of the MCA was selected for an end-to-side microanastomosis with the radial graft using ten U-clips. The total temporary occlusion time was 13 min. The post-operative course was uneventful. CONCLUSION: Endoscopic technique provides improved patient satisfaction, especially in terms of length of the surgical incision, when compared to the conventional approach. Combined with the innovative use of U-clips, this case illustrates how new technologies can simplify ECA-ICA bypass surgery while yielding a better cosmetic and functional outcome.
Authors:
P Ferroli; G Bisleri; P Nakaji; E Albanese; F Acerbi; G Polvani; G Broggi
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-10-16
Journal Detail:
Title:  Minimally invasive neurosurgery : MIN     Volume:  52     ISSN:  1439-2291     ISO Abbreviation:  Minim Invasive Neurosurg     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-10-19     Completed Date:  2010-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440973     Medline TA:  Minim Invasive Neurosurg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  186-9     Citation Subset:  IM    
Copyright Information:
Georg Thieme Verlag KG Stuttgart * New York.
Affiliation:
Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy. ferrolipaolo@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Carotid Artery, Internal, Dissection / pathology,  radiography,  surgery*
Cerebral Revascularization / instrumentation,  methods*
Cicatrix / prevention & control
Craniotomy / methods
Endoscopy / methods*
Female
Forearm / blood supply,  surgery
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Patient Satisfaction
Petrous Bone / pathology,  surgery
Postoperative Complications / etiology,  prevention & control
Radial Artery / anatomy & histology,  surgery*,  transplantation*
Surgical Instruments
Treatment Outcome
Vascular Surgical Procedures / instrumentation,  methods*

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


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