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首页> 外文期刊>Neurosurgery >Self-closing U-clips for intracranial microanastomoses in high-flow arterial bypass: technical case report.
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Self-closing U-clips for intracranial microanastomoses in high-flow arterial bypass: technical case report.

机译：高流量动脉旁路中颅内微吻合器的自闭合U型夹：技术案例报告。

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OBJECTIVE: Self-closing nitinol U-clips (Medtronic, Inc., Minneapolis, MN) have been used to create vascular microanastomoses by vascular surgeons. This device eliminates the need for suture management and knot tying. Therefore, a high-quality interrupted microvascular anastomosis can be obtained in a shorter period of time. This is the first report of a U-clip intracranial arterial microanastomosis for a high-flow extracranial-intracranial bypass using a radial artery graft. CLINICAL PRESENTATION: A 24-year-old woman with a history of chronic headache was admitted to the National Neurological Institute Carlo Besta after a brain computed tomographic scan revealed a giant serpentine aneurysm of her right middle cerebral artery. Magnetic resonance angiography and four-vessel angiography confirmed the diagnosis and ruled out other lesions. INTERVENTION: A radial artery graft was used to create a high-flow bypass between the external carotid artery and the postaneurysmal M2 segment of the right middle cerebral artery. Nitinol self-closing U-clips were used for the interrupted intracranial microanastomosis. After intraoperative near-infrared indocyanine green video angiography confirmed the bypass patency, the aneurysm could be trapped. CONCLUSION: The postoperative course was uneventful. The patient was discharged on the seventh postoperative day and was neurologically intact. Postoperative angiography documented the successful exclusion of the aneurysm and the presence of revascularization of the distal branches of the right middle cerebral artery through the bypass. This case demonstrates the efficacy of U-clips for intracranial microanastomoses.
机译：目的：自闭式镍钛合金U形夹（明尼苏达州明尼阿波利斯的Medtronic公司）已被血管外科医师用于制造血管微吻合器。该设备消除了缝合管理和打结的需要。因此，可以在较短的时间内获得高质量的间断性微血管吻合。这是使用-动脉移植物进行高流量颅外-颅内旁路手术的U形颅内动脉微吻合术的首次报道。临床表现：一名具有慢性头痛病史的24岁妇女在接受计算机断层扫描后发现其右大脑中动脉有巨大的蛇形动脉瘤后，被美国国家神经病学研究所的卡洛·贝斯塔（Carol Besta）录取。磁共振血管造影和四支血管造影证实了诊断，并排除了其他病变。干预：使用radial动脉移植物在颈外动脉和右中脑动脉瘤后M2段之间形成高流量旁路。镍钛诺自闭合U型夹用于中断的颅内微吻合术。术中近红外吲哚菁绿视频血管造影证实旁路通畅后，动脉瘤可被捕获。结论：术后病程平稳。该患者在术后第七天出院，神经系统完整。术后血管造影证明成功排除了动脉瘤，并且通过旁路术对右大脑中动脉远端分支进行了血运重建。该病例证明了U形夹对颅内微吻合的功效。

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