Artikel
C-PORT-assisted high-flow extracranial/intracranial bypass in patients with symptomatic carotid artery occlusion: First experience and safety analysis
C-PORT assistierter High-Flow EC-IC Bypass bei Patienten mit symptomatischem Verschluss der A. carotis interna: Dokumentation der ersten Erfahrungen
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Autoren
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D. Hänggi
- Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf, Deutschland
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H.-J. Steiger
- Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: Preliminary experience with the C-Port System (Cardica, Inc, Redwood City, California) to enable rapid automated anastomosis has been reported in coronary artery bypass surgery. The goal of the current study was to define feasibility and safety of this minimally occlusive method for high-flow extracranial/intracranial (EC/IC) bypass surgery.
Methods: In a prospective study design patients with symptomatic carotid artery occlusion are selected for C-PORT assisted high-flow EC/IC bypass surgery if they meet the following conditions: (1) Transient or moderately permanent symptoms of focal ischemia; (2) carotid artery occlusion; (3) hemodynamic instability; and (4) informed consent. All cerebral anastomoses were performed with the C-PORT flex-A system (Cardica, Inc, Redwood City, California).
Results: So far three patients obtained the high-flow EC/IC bypass (STA-M1/M2) unilateral with a radial artery graft. Median occlusion time was 18 minutes. There was no perioperative complication and intraoperative digital subtraction angiogram (DSA) revealed excellent bypass function. One patient developed a limited zone of infarction on CT 8 days postoperatively without clinical symptomatology due to transient vasospasm of Sylvian arteries. Transient asymptomatic extracranial spasm of the donor artery and the radial artery graft was evident in another case as shown by the follow-up DSA 1 week postoperatively.
Conclusions: C-PORT-assisted high-flow extracranial/intracranial bypass in patients with symptomatic carotid artery occlusion is a technically feasible procedure with minimal occlusion time. Further experience is necessary for a conclusive comparison with the standard and laser assisted methods for high-flow bypass surgery.
