Incision Edge “Lifting Method” in Cerebral Bypass Surgery: A Novel Optional Technique for Narrow or Thin Recipient Arteries

Miyazaki, Ryohei; Murata, Hidetoshi; Sato, Mitsuru; Ueno, Ryu; Ikegaya, Naoki; Matsumoto, Shutaro; Abé, Hiroyuki; Nagao, Kagemichi; Shimizu, Nobuyuki; Tateishi, Kensuke; Suenaga, Jun; Yamamoto, Tetsuya

doi:10.1016/j.wneu.2020.06.077

Cited by 2 publications

(1 citation statement)

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“…CIA arterial end-to-side anastomosis models mimic the end-to-side anastomosis between perfectly matched arteries. However, mismatched vessels are inevitably encountered in cerebrovascular bypass surgery even if there is careful preoperative planning ( 6 , 22 ), and the difficulty of anastomosis increases when very thin-walled vessels are encountered ( 23 ). The artery-to-vein microvascular training model is a good model to mimic this situation because veins are thinner, more fragile, easier to damage, and more prone to collapse than arteries.…”

Section: Discussionmentioning

confidence: 99%

Three types of end-to-side microvascular anastomosis training models using rat common iliac arteries

et al. 2023

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Background: Instead of only practicing these perfectly matched end-to-side anastomoses in microsurgical laboratories, we must learn how to perform these so-called “imperfect” end-to-side anastomoses in the laboratory.MethodsThree types of end-to-side microvascular anastomoses using the rat common iliac artery (CIA), one with the proximal end of the CIA to the contralateral side of the CIA, another with the distal end of the CIA to the contralateral side of the CIA, and the third with the distal end of the CIA to the ipsilateral side of the common iliac vein (CIV), were presented to simulate different end-to-side anastomosis situations in a microsurgical laboratory. Diameters of CIA and CIV, distances between temporary clips, the length of arteriotomy or venotomy, and the distribution of stitches were recorded. The patency rates were evaluated immediately after the anastomosis was completed and 30 min later. After animal euthanasia, the donor vessel was cut close to the anastomotic site, and the orifice size and intimal attachment were evaluated by inspecting them through inside the vessel.ResultsThe diameters of the CIA and CIV were 0.8–1.2 mm and 1.2–1.5 mm, respectively. The end-to-side microvascular anastomosis arteriotomy or venotomy is approximately 2.00–2.50 mm, the distance between the aneurysm clips on the recipient CIA or CIV is approximately 4.00–7.00 mm, and the distance between the corner of the arteriotomy or venotomy and the temporary aneurysm clip was 1.00–3.00 mm. Three types of end-to-side anastomoses using the CIA were successfully performed, and 100% patency rates were achieved immediately and 30 min postoperatively. Good distribution of stitches, wide orifice, and intimal attachment were recorded in the study in all groups.ConclusionsThree types of end-to-side anastomoses using rat CIAs could be efficiently used to mimic three different anastomotic situations.

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Section: Discussionmentioning

confidence: 99%