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59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

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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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  • corresponding author P. Ferroli - Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy
  • G. Bisleri - Division of Cardiac Surgery, University of Brescia Medical School, Brescia, Italy
  • G. Tringali - Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy
  • M. Broggi - Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy
  • A. Miserocchi - Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy
  • G. Polvani - Department of Cardiac Surgery, Centro Cardiologico Monzino, Milano, Italy
  • G. Broggi - Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 019

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc287.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Ferroli 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 vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

Text

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.