Technical Tips for Microvascular Anastomosis: How We Prepare Appropriate Operative Field and Manage Troubles in Bypass Surgery

DOI 3 Citations 13 References
  • ISHIKAWA Tatsuya
    Department of Neurological Surgery, Research Institute for Brain & Blood Vessels-Akita
  • MOROI Jyunta
    Department of Neurological Surgery, Research Institute for Brain & Blood Vessels-Akita
  • TAMAKAWA Noriyuki
    Department of Neurological Surgery, Research Institute for Brain & Blood Vessels-Akita
  • MUTOH Tatsushi
    Department of Neurological Surgery, Research Institute for Brain & Blood Vessels-Akita
  • YASUI Nobuyuki
    Department of Neurological Surgery, Research Institute for Brain & Blood Vessels-Akita

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Other Title
  • 血行再建術　　練習できないバイパス手術のコツ―上手な「場」の作成やその他のトラブルシューティング―
  • ―上手な「場」の作成やその他のトラブルシューティング―

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Description

Complex cerebral aneurysm and hemodynamic occlusive cerebrovascular disease require microvascular-anastomosis, mainly superficial temporal artery (STA) to middle cerebral artery (MCA) bypass, as treatment tactics. Preparing a clean, well-drained operative field with a platform for placing microvascular sutures, good visualization of the arteriotomy, and steady hand movements are necessary to achieve a safe and secure bypass procedure. We present representative troubles that may be encountered in STA-MCA bypass surgery and describe how to manage those troubles. We stress that patients whose bypass appears to occlude immediately after surgery are sometimes encountered, because of problems in the STA itself such as spasm, dissection, distortion or pinching by surrounding tissues.<br>

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