| Endoscopic radial artery harvesting for U-clip EC-IC bypass in the treatment of a giant petrous internal carotid artery aneurysm: technical case report. | |
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MedLine Citation:
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PMID: 19838973 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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P Ferroli; G Bisleri; P Nakaji; E Albanese; F Acerbi; G Polvani; G Broggi |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-10-16 |
Journal Detail:
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Title: Minimally invasive neurosurgery : MIN Volume: 52 ISSN: 1439-2291 ISO Abbreviation: Minim Invasive Neurosurg Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-10-19 Completed Date: 2010-01-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9440973 Medline TA: Minim Invasive Neurosurg Country: Germany |
Other Details:
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Languages: eng Pagination: 186-9 Citation Subset: IM |
Copyright Information:
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Georg Thieme Verlag KG Stuttgart * New York. |
Affiliation:
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Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy. ferrolipaolo@hotmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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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