Purpose: To report experience on the use of self-closing nitinol U-Clips for different types of intracranial arterial microanastomosis. Methods: We treated 7 patients (3 females and 4 males, age ranging from 25 to 68 yo) admitted from November 2005 to January 2008 to the Neurological Institute C. Besta of Milan. One patient had cerebral hypoperfusion and the others a complex intracranial aneurysm. In each patient a bypass procedure was completed by using self-closing Nitinol U-Clips for intracranial arterial microanastomoses. Results: The total time of temporary occlusion was 15.71±4.386 min. Bypass patency was confirmed intraoperatively by near-infrared indocyanine green videoangiography and microdoppler in each patient. No spasm of the graft was encountered and immediate post-operative bypass patency was confirmed in 6/7 patients. The graft thrombosed in 1 patient with antiphospholipid syndrome. 1 patient died from a massive Subarachnoid Hemorrhage due to rupture of an aneurysm while waiting for an endovascular procedure. In the 5 patients at the last follow-up, long-term patency of the bypass was confirmed and no neurological deficits occurred related to the procedure. Conclusion: This is the first report of the use of U-Clips for intracranial microanastomosis. Our data indicated that it is a safe technique, reduces the time taken to perform an anastomosis and the risk of an ischemic complication. Further studies of the longer-term patency of bypass as performed with U-Clips are required.
Self-closing nitinol U-Clips for intracranial arterial microanastomosis: a preliminary experience on seven cases / P. Ferroli, F. Acerbi, G. Tringali, G. Polvani, E. Parati, G. Broggi. - In: ACTA NEUROCHIRURGICA. - ISSN 0001-6268. - 151:8(2009), pp. 969-976.
|Titolo:||Self-closing nitinol U-Clips for intracranial arterial microanastomosis: a preliminary experience on seven cases|
ACERBI, FRANCESCO (Secondo)
PARATI, EUGENIO (Penultimo)
|Parole Chiave:||Arterial microanastomoses; Intracranial bypass; UClip; Cerebral aneurysm|
|Settore Scientifico Disciplinare:||Settore MED/23 - Chirurgia Cardiaca|
|Data di pubblicazione:||2009|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s00701-009-0365-7|
|Appare nelle tipologie:||01 - Articolo su periodico|