The Valveless Saphenous Vein Graft Technique for EC-IC High-Flow Bypass: Technical Note.

Abstract:

OBJECTIVE:Extracranial to intracranial (EC-IC) high-flow bypass using radial artery or saphenous vein (SV) graft has remained vital for complex aneurysms. If an Allen test is positive, the radial artery cannot be harvested because of poor palmer collateral circulation. The valves are thought to be one of causes of SV graft failure. Herein we illustrate the "valveless SV graft technique" as bypass conduits. METHODS:Between August 2014 and December 2014 at the Department of Neurosurgery at Teishinkai Hospital, 4 patients whose Allen test was positive underwent EC-IC bypass with the valveless SV graft for complex internal carotid artery (ICA) aneurysm. After SV harvesting, we identified the SV valve, cut it, and performed an end-to-end anastomosis using the fish mouth trimming technique. Graft patency was confirmed by computed tomography angiography. RESULTS:We have not encountered any problems related to graft failure, and all valveless SV grafts were patent during the follow-up period (median, 210 days; interquartile range, 93-287 days). CONCLUSIONS:The valveless SV graft technique is a useful technique in patients with complex ICA aneurysms who undergo EC-IC high-flow bypass with therapeutic ICA occlusion and whose Allen tests are positive.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Matsukawa H,Tanikawa R,Kamiyama H,Tsuboi T,Noda K,Ota N,Miyata S,Tokuda S

doi

10.1016/j.wneu.2015.12.009

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

35-8

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(15)01679-4

journal_volume

87

pub_type

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