Half-tied Stay Suture Technique for Cerebrovascular End-to-side Anastomosis: A Technique to Expand the View of the Hidden Ostium.

Half-tied Stay Suture Technique for Cerebrovascular End-to-side Anastomosis: A Technique to Expand the View of the Hidden Ostium. Neurol Med Chir (Tokyo). 2019 Jun 05;: Authors: Shimizu S, Osawa S, Kuroda H, Koizumi H, Mochizuki T, Kumabe T Abstract In cerebrovascular end-to-side anastomosis, thick, hard donor arteries overlying thin recipient arteries impair the view of the ostium, and may result in occlusion of the anastomosis. To improve the intraoperative view, we modified the stay sutures. After performing standard recipient arteriotomy and placing the first stay suture, we half-tied the second stay suture to leave a loop: half-tied stay suture (HSS). The thread of the HSS was secured with a clip to avoid slippage. For suturing side A, the clip pulling on the HSS was gently moved to the opposite side of side A, i.e. to side B, and the donor artery was revolved by several degrees to side B; the first stay suture was used as the fulcrum. Under the expanded view of the ostium, untied interrupted sutures were placed on side A. Then the donor vessel was revolved to the opposite side and side B was sutured in the same manner. At last, the HSS and all other sutures were tied fully. Our HSS method was used in three adults who underwent superficial temporal- to middle cerebral artery anastomosis despite anticipated poor visibility of the ostium. Compared with the conventional method, the view of the ostium was expanded with less manipula...
Source: Neurologia Medico-Chirurgica - Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research