gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

The minimally occlusive microvascular anastomosis technique using a temporary intraluminal shunt: a prospective technique to minimize brain ischemia time during STA-MCA bypass: experimental note

Die minimalokklusive Mikrogefäßanastomosentechnik über einen temporären intraluminären Shunt: eine Möglichkeit, die Gehirnischemiezeit bei der STAMCA Bypass zu reduzieren : experimentelle Vorarbeit

Meeting Abstract

  • corresponding author K. G. Krishnan - Department of Neurological Surgery, Carl-Gustav-Carus University, Hospital Dresden
  • P. Tsirekidze - Department of Neurological Surgery, Carl-Gustav-Carus University, Hospital Dresden
  • T. Pinzer - Department of Neurological Surgery, Carl-Gustav-Carus University, Hospital Dresden
  • G. Schackert - Department of Neurological Surgery, Carl-Gustav-Carus University, Hospital Dresden

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP067

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0335.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Krishnan et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Suturing microvessels mandates their occlusion during the period of anastomosis. Although ischemia is well tolerated by other tissue types, the brain is quite sensitive to even short ischemic windows. Non-occlusive anastomotic techniques have been developed recently. These are confined to vessels with luminal diameters more than 3 mm. We have evolved a novel technique that can be used with microvessels, as pertinent to STA-MCA bypass. Our Aim is to describe a new technique of suturing microvessels with persistent perfusion via a temporary intraluminal microshunt.

Methods

Experiments were conducted in Wistar rats. Abdominal aorta grafts were explanted from donor rats. A soft silicon microcatheter was introduced into the lumen of this graft. The abdominal aorta of a recipient rat was prepared for end-to-side microvascular anastomosis. Acland clamps were applied and a linear arteriotomy was made. One end of the graft-clad microcatheter was introduced into the lumen and occluded with a fenestrated Acland clamp. At a more distal part, a similar arteriotomy was performed and the other end of the microcatheter was introduced into the lumen and clamped with a fenestrated Acland clip. This created a temporary shunt thorough the graft-clad microcatheter. Now the graft was anastomosed to the arteriotomies at both ends, over the microcatheter, in an end-to-side fashion. The microcatheter was explanted from the vessel lumen through an arteriotomy in the middle of the graft. The graft was clipped shortly to close this arteriotomy. The mean total occlusion time before perfusion was reestablished accounted to 3.7 minutes. This experiment was repeated in 12 animals (in 6 with, and in 6 without heparin) without technical complications. As controls conventional anastomoses was made in two animals.

Results

All anastomoses were patent. There were no technical complications.

Conclusions

We have described a new technique for performing microvascular anastomoses over a temporary intraluminal microcatheter shunt.