Heel Suturing on the Donor Vessel prior to Arteriotomy for End-to-side Cerebrovascular Anastomoses

Microvascular anastomosis is a common procedure in cerebrovascular surgery. End-to-side anastomoses were the most common procedure for extracranial-to-intracranial bypass. Many techniques were used to reduce clamping time of the recipient vessel. The authors innovated heel suturing on the donor vessel prior to arteriotomy (HSDA) technique from the previously described double sutures on the toe and heel of the donor vessel before arteriotomy technique for end-to-side anastomosis. Forty-three end-to-side anastomoses using the HSDA technique were collected from 32 patients.