Document Detail


Self-closing Nitinol U-Clips for intracranial arterial microanastomosis: a preliminary experience on seven cases.
MedLine Citation:
PMID:  19444375     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report experience on the use of self-closing nitinol U-Clips for different types of intracranial arterial microanastomosis. METHODS: We treated 7 patients (3 females and 4 males, age ranging from 25 to 68 yo) admitted from November 2005 to January 2008 to the Neurological Institute C. Besta of Milan. One patient had cerebral hypoperfusion and the others a complex intracranial aneurysm. In each patient a bypass procedure was completed by using self-closing Nitinol U-Clips for intracranial arterial microanastomoses. RESULTS: The total time of temporary occlusion was 15.71 +/- 4.386 min. Bypass patency was confirmed intraoperatively by near-infrared indocyanine green videoangiography and microdoppler in each patient. No spasm of the graft was encountered and immediate post-operative bypass patency was confirmed in 6/7 patients. The graft thrombosed in 1 patient with antiphospholipid syndrome. 1 patient died from a massive Subarachnoid Hemorrhage due to rupture of an aneurysm while waiting for an endovascular procedure. In the 5 patients at the last follow-up, long-term patency of the bypass was confirmed and no neurological deficits occurred related to the procedure. CONCLUSION: This is the first report of the use of U-Clips for intracranial microanastomosis. Our data indicated that it is a safe technique, reduces the time taken to perform an anastomosis and the risk of an ischemic complication. Further studies of the longer-term patency of bypass as performed with U-Clips are required.
Authors:
P Ferroli; F Acerbi; G Tringali; G Polvani; E Parati; G Broggi
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-05-15
Journal Detail:
Title:  Acta neurochirurgica     Volume:  151     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-24     Completed Date:  2009-10-26     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  969-76; discussion 976     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy. ferrolipaolo@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography
Brain Ischemia / prevention & control
Cerebral Arteries / pathology,  radiography,  surgery*
Female
Humans
Intracranial Aneurysm / pathology,  radiography,  surgery*
Male
Middle Aged
Monitoring, Intraoperative
Neurosurgical Procedures / instrumentation*,  methods
Outcome Assessment (Health Care)
Postoperative Complications / prevention & control
Surgical Instruments / standards,  statistics & numerical data*,  trends
Treatment Outcome
Vascular Surgical Procedures / instrumentation*,  methods
Video Recording

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