Document Detail

Less invasive technique for EC-IC bypass.
MedLine Citation:
PMID:  18496950     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We introduce less invasive technique for superficial temporal to middle cerebral artery (STA-MCA) anastomosis, and also described an innovative technique to preoperatively identify the recipient artery using three dimensional CT angiography (3D CTA). Objective. In a period of 28 months between January 2004 and April 2006, 39 EC-IC bypass were performed for hemodynamic compromised patients (including 9 patients with Moyamoya disease) using less invasive technique. METHODS: Operative technique is as follows: 1) A parietal or frontal branch of STA and cortical arteries could be identified on the original images of 3D CTA. The most suitable segment of both the artery provided as donor and recipient arteries for EC-IC bypass. The distance between the afore-mentioned segment of donor artery (STA) and the superior border of the helix were calculated. 2) A 5 cm linear skin incision on the STA, the center of which was the point measured on preoperative 3D CTA, was made. The temporal muscle was divided in the same fashion, and a 3 cm small craniotomy was made. The recipient artery could be identified on the center of the craniotomy. End-to-side anastomosis was performed in the usual way. RESULTS: Operation times were 115-172 min (mean 154 min) and intraoperative blood loss was 20-60 ml (mean 38 ml). All bypasses were patent on the post-operative 3D CTA. CONCLUSIONS: This technique for EC-IC bypass was less invasive and cosmetically excellent. 3D CTA provides useful information for planning of the less invasive EC-IC bypass.
Y Kaku; H Watarai; J Kokuzawa; T Tanaka; T Andoh
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  103     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2008  
Date Detail:
Created Date:  2008-05-23     Completed Date:  2008-07-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  83-6     Citation Subset:  IM    
Department of Neurosurgery, Asahi University Murakami Memorial Hospital, Gifu, Japan.
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MeSH Terms
Cerebral Revascularization / methods*
Cerebrovascular Circulation / physiology*
Cerebrovascular Disorders / physiopathology,  surgery*
Magnetic Resonance Angiography / methods
Microsurgery / methods*
Retrospective Studies
Tomography, Emission-Computed, Single-Photon

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