Article
Endoscopic radial artery harvesting for U-clip EC-IC bypass in the treatment of a giant petrous internal carotid artery aneurysm. Technical case report
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Published: | May 30, 2008 |
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Objective: The purpose of extracranial to intracranial (EC-IC) bypass is to augment cerebral blood flow. This procedure entails connection of a medium conduit (artery or vein) between extracranial and intracranial circulation. Advances in surgical technique have greatly expanded the options available for performing an EC-IC bypass. This report documents the successful use of a radial artery endoscopically harvested for cerebral revascularization. U-clips were used to make easier and faster the intracranial anastomosis as discussed elsewhere.
Methods: A 68-year-old woman affected by long-lasting diplopia was found to harbour a giant right internal carotid artery aneurysm that increased in volume between september 2006 and september 2007. This patient was treated with a novel EC-IC bypass technique that employs endoscopy to minimize arm damage due to radial artery harvesting and self closing-U-clip to simplify the intracranial microanastomosis and minimize the temporary occlusion time. After the intraoperative control of bypass patency the aneurysm could be trapped and debulked.
Results: Both intraoperative near infrared indocyanine green videoangiography and postoperative 3D angioCT demonstrated the patency of the bypass and aneurysm exclusion. The post-operative course was uneventful and she could be sent home in the VII post-operative day without any new neurological deficit. Both cosmetical result and arm functional recovery were excellent, with only minimal post-operative discomfort.
Conclusions: Endoscopic radial artery harvesting is feasible and useful to minimize arm damage. U-clips can make easy and faster the intracranial anastomosis.