The use of high-flow extracranial-intracranial artery bypass in pathology of the cerebral and brachiocephalic arteries: technical features and surgical outcomes

Dubovoy, A. V.; Ovsyannikov, K. S.; Guzhin, V E; Cherepanov, A V; Galaktionov, D M; Перфильев, А. М.; Соснов, А. О.

doi:10.17116/neiro20178125-21

Cited by 3 publications

(2 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In strokes, studies have shown benefit in candidates requiring urgent reperfusion when intra-arterial thrombolysis (ITA) is unavailable or contraindicated, with one study showing significant improvement in NIH stroke scales, neurological outcomes, and “good” outcomes (as defined by Rankin scale). [ 8 13 17 33 ] The role and benefit of surgical anastomotic intervention in Moyamoya disease are well-established, with marked benefit noted in numerous studies. [ 9 23 35 ] Furthermore, bypass technique is used in selected complex cerebral aneurysms.…”

Section: Introductionmentioning

confidence: 99%

Microvascular anastomosis under 3D exoscope or endoscope magnification: A proof-of-concept study

Belykh¹,

George²,

Zhao³

et al. 2018

Surg Neurol Int

View full text Add to dashboard Cite

Background:Extracranial–intracranial bypass is a challenging procedure that requires special microsurgical skills and an operative microscope. The exoscope is a tool for neurosurgical visualization that provides view on a heads-up display similar to an endoscope, but positioned external to the operating field, like a microscope. The authors carried out a proof-of-concept study evaluating the feasibility and effectiveness of performing microvascular bypass using various new exoscopic tools.Methods:We evaluated microsurgical procedures using a three-dimensional (3D) endoscope, hands-free robotic automated positioning two-dimensional (2D) exoscope, and an ocular-free 3D exoscope, including surgical gauze knot tying, surgical glove cutting, placental vessel anastomoses, and rat vessel anastomoses. Image quality, effectiveness, and feasibility of each technique were compared among different visualization tools and to a standard operative microscope.Results:3D endoscopy produced relatively unsatisfactory resolution imaging. It was shown to be sufficient for knot tying and anastomosis of a placental artery, but was not suitable for anastomosis in rats. The 2D exoscope provided higher resolution imaging, but was not adequate for all maneuvers because of lack of depth perception. The 3D exoscope was shown to be functional to complete all maneuvers because of its depth perception and higher resolution.Conclusion:Depth perception and high resolution at highest magnification are required for microvascular bypass procedures. Execution of standard microanastomosis techniques was unsuccessful using 2D imaging modalities because of depth-perception-related constraints. Microvascular anastomosis is feasible under 3D exoscopic visualization; however, at highest magnification, the depth perception is inferior to that provided by a standard operative microscope, which impedes the procedure.

show abstract

Section: Introductionmentioning

confidence: 99%

Microvascular anastomosis under 3D exoscope or endoscope magnification: A proof-of-concept study

Belykh¹,

George²,

Zhao³

et al. 2018

Surg Neurol Int

View full text Add to dashboard Cite

show abstract

“…The RA is used in neurosurgery for high-flow bypass procedures involving complex aneurysms situated between the middle cerebral artery and external carotid artery [3]. Notably, occlusion or thrombus formation within the graft can lead to severe complications [16]. Additionally, RA is commonly used in coronary artery bypass grafting, with some histological studies reported [17].…”

Section: Introductionmentioning

confidence: 99%

Pathological Findings of Donor Vessels in Bypass Surgery

Nounaka,

Murai,

Kubota

et al. 2024

JCM

View full text Add to dashboard Cite

(1) Background Cerebral revascularization is necessary to treat intracranial arterial stenosis caused by moyamoya disease, atherosclerosis, or large complex aneurysms. Although various donor vascular harvesting methods have been reported safe, there are no reports on the histological evaluation of donor vessels for each disease, despite the variety of diseases wherein vascular anastomosis is required. (2) Methods Pathological findings of the superficial temporal artery (STA), radial artery (RA), occipital artery (OA), and saphenous vein (SV) harvested at the institution were analyzed. Patients classified according to aneurysm, atherosclerosis, and moyamoya disease were assessed for pathological abnormalities, medical history, age, sex, smoking, and postoperative anastomosis patency. (3) Results There were 38 cases of atherosclerosis, 15 cases of moyamoya disease, and 30 cases of aneurysm in 98 donor vessels (mean age 57.2) taken after 2006. Of the 84 STA, 11 RA, 2 OA, and 1 SV arteries that were harvested, 71.4% had atherosclerosis, 11.2% had dissection, and 10.2% had inflammation. There was no significant difference in the proportion of pathological findings according to the disease. A history of hypertension is associated with atherosclerosis in donor vessels. (4) Conclusions This is the first study to histologically evaluate the pathological findings of donor vessels according to disease. The proportion of dissection findings indicative of vascular damage due to surgical manipulation was not statistically different between the different conditions.

show abstract

Large and Giant Aneurysms

Ren

2022

Eight Aneurysms

View full text Add to dashboard Cite

The use of high-flow extracranial-intracranial artery bypass in pathology of the cerebral and brachiocephalic arteries: technical features and surgical outcomes

Cited by 3 publications

References 47 publications

Microvascular anastomosis under 3D exoscope or endoscope magnification: A proof-of-concept study

Microvascular anastomosis under 3D exoscope or endoscope magnification: A proof-of-concept study

Pathological Findings of Donor Vessels in Bypass Surgery

Large and Giant Aneurysms

Contact Info

Product

Resources

About