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The preparation of anastomosis site at the insular segment of middle cerebral artery
BACKGROUND: An anastomosis at the insular segment of the middle cerebral artery (M2) is often required in cerebral reconstruction with high- or low-flow bypass. It is necessary to create a shallow, wide, fixed, and bloodless anastomosis field to achieve a safe and quick anastomosis for low surgical...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093771/ https://www.ncbi.nlm.nih.gov/pubmed/25024885 http://dx.doi.org/10.4103/2152-7806.133992 |
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author | Katsuno, Makoto Tanikawa, Rokuya Izumi, Naoto Hashimoto, Masaaki |
author_facet | Katsuno, Makoto Tanikawa, Rokuya Izumi, Naoto Hashimoto, Masaaki |
author_sort | Katsuno, Makoto |
collection | PubMed |
description | BACKGROUND: An anastomosis at the insular segment of the middle cerebral artery (M2) is often required in cerebral reconstruction with high- or low-flow bypass. It is necessary to create a shallow, wide, fixed, and bloodless anastomosis field to achieve a safe and quick anastomosis for low surgical morbidity. We describe a method to perform a safe and quick anastomosis. METHODS: From 2009 to 2013, the technique was used in 20 procedures to create an extracranial M2 high-flow bypass. The Sylvian fissure was dissected wide open to expose the M2. A silicon sheet was laid under M2 and the absorbable gelatin-compressed sponges were inserted between M2 and the insula cortex to lift up the M2 and fix it. The rolling surgical sheets were placed at each edge of the dissected Sylvian fissure, instead of brain spatulas. Finally, a small suction tube was placed at the Sylvian fissure and cerebrospinal fluid was continuously sucked. The postoperative patency of the bypass was evaluated by three-dimensional computed tomographic angiography (3D-CTA) in the acute and chronic stages. RESULTS: In all cases, the operation field acquired for the anastomosis was adequate. The average time required for the procedure was 19 min 27 s. Good patency of all high-flow grafts was confirmed by postoperative three-dimensional computed tomography angiography (3D-CTA). CONCLUSION: In our series, there were no technical complications related to the anastomosis at M2 performed according to our method. |
format | Online Article Text |
id | pubmed-4093771 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-40937712014-07-14 The preparation of anastomosis site at the insular segment of middle cerebral artery Katsuno, Makoto Tanikawa, Rokuya Izumi, Naoto Hashimoto, Masaaki Surg Neurol Int Technical Note BACKGROUND: An anastomosis at the insular segment of the middle cerebral artery (M2) is often required in cerebral reconstruction with high- or low-flow bypass. It is necessary to create a shallow, wide, fixed, and bloodless anastomosis field to achieve a safe and quick anastomosis for low surgical morbidity. We describe a method to perform a safe and quick anastomosis. METHODS: From 2009 to 2013, the technique was used in 20 procedures to create an extracranial M2 high-flow bypass. The Sylvian fissure was dissected wide open to expose the M2. A silicon sheet was laid under M2 and the absorbable gelatin-compressed sponges were inserted between M2 and the insula cortex to lift up the M2 and fix it. The rolling surgical sheets were placed at each edge of the dissected Sylvian fissure, instead of brain spatulas. Finally, a small suction tube was placed at the Sylvian fissure and cerebrospinal fluid was continuously sucked. The postoperative patency of the bypass was evaluated by three-dimensional computed tomographic angiography (3D-CTA) in the acute and chronic stages. RESULTS: In all cases, the operation field acquired for the anastomosis was adequate. The average time required for the procedure was 19 min 27 s. Good patency of all high-flow grafts was confirmed by postoperative three-dimensional computed tomography angiography (3D-CTA). CONCLUSION: In our series, there were no technical complications related to the anastomosis at M2 performed according to our method. Medknow Publications & Media Pvt Ltd 2014-06-05 /pmc/articles/PMC4093771/ /pubmed/25024885 http://dx.doi.org/10.4103/2152-7806.133992 Text en Copyright: © 2014 Katsuno M. http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Technical Note Katsuno, Makoto Tanikawa, Rokuya Izumi, Naoto Hashimoto, Masaaki The preparation of anastomosis site at the insular segment of middle cerebral artery |
title | The preparation of anastomosis site at the insular segment of middle cerebral artery |
title_full | The preparation of anastomosis site at the insular segment of middle cerebral artery |
title_fullStr | The preparation of anastomosis site at the insular segment of middle cerebral artery |
title_full_unstemmed | The preparation of anastomosis site at the insular segment of middle cerebral artery |
title_short | The preparation of anastomosis site at the insular segment of middle cerebral artery |
title_sort | preparation of anastomosis site at the insular segment of middle cerebral artery |
topic | Technical Note |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093771/ https://www.ncbi.nlm.nih.gov/pubmed/25024885 http://dx.doi.org/10.4103/2152-7806.133992 |
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