Document Detail


A simple surgical technique of direct anastomosis for treatment of moyamoya disease: technical note.
MedLine Citation:
PMID:  15451295     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: An arteriotomy on a branch of the middle cerebral artery (MCA) is required in the procedure of the direct anastomosis for the treatment of moyamoya disease, and the artery comes to be collapsed after blood is washed out. The phenomenon makes the microsurgical procedure difficult during direct anastomosis. METHODS: A piece of 3-0 blue monofilament polypropylene suture (PROLENE*, ETHICON Inc., a Johnson & Johnson Company, Somerville, New Jersey) was inserted into the lumen of the recipient artery though the ostium after termination of arteriotomy. The diameter of 3-0 PROLENE* was between 0.20 and 0.249 mm. PROLENE*, a length that was more than the length of the arteriotomy and was less than the distance between the 2 occlusion clamps placed on the recipient artery. At this time, the lumen was reopened and the wall of the recipient artery was easily passed by a microneedle with 11-0 monofilament without injury to the posterior wall of the recipient artery by the microneedle. Confirmation as to whether the microneedle snagged and injured the posterior wall of the recipient artery or not was unnecessary with this method. RESULTS: Anastomosis was easily performed using this technique for the treatment of moyamoya disease. CONCLUSIONS: Clinical application of the present technique makes the anastomotic procedure easy, even when the diameter of the recipient artery is as small as 0.5 mm.
Authors:
Hajime Touho
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  62     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-28     Completed Date:  2004-10-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  366-8     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Touho Neurosurgical Clinic, Osaka 563-0026, Japan.
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical / methods*
Cerebral Revascularization / methods*
Humans
Middle Cerebral Artery / surgery
Moyamoya Disease / surgery*
Suture Techniques
Temporal Arteries / surgery

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


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