Automated, compliant, high-flow common carotid to middle cerebral artery bypass

Dacey, Ralph G; Zipfel, Gregory J; Ashley, William W; Chicoine, Michael R; Reinert, Michael (2008). Automated, compliant, high-flow common carotid to middle cerebral artery bypass. Journal of neurosurgery, 109(3), pp. 559-64. Charlottesville, Va.: American Association of Neurological Surgeons 10.3171/JNS/2008/109/9/0559

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The authors describe the use of the Cardica C-Port xA Distal Anastomosis System to perform an automated, high-flow extracranial-intracranial bypass. The C-Port system has been developed and tested in coronary artery bypass surgery for rapid distal coronary artery anastomoses. Air-powered, it performs an automated end-to-side anastomosis within seconds by nearly simultaneously making an arteriotomy and inserting 13 microclips into the graft and recipient vessel. Intracranial use of the device was first simulated in a cadaver prepared for microsurgical anatomical dissection. The authors used this system in a 43-year-old man who sustained a subarachnoid hemorrhage after being assaulted and was found to have a traumatic pseudoaneurysm of the proximal intracranial internal carotid artery. The aneurysm appeared to be enlarging on serial imaging studies and it was anticipated that a bypass would probably be needed to treat the lesion. An end-to-side bypass was performed with the C-Port system using a saphenous vein conduit extending from the common carotid artery to the middle cerebral artery. The bypass was demonstrated to be patent on intraoperative and postoperative arteriography. The patient had a temporary hyperperfusion syndrome and subsequently made a good neurological recovery. The C-Port system facilitates the performance of a high-flow extracranial-intracranial bypass with short periods of temporary arterial occlusion. Because of the size and configuration of the device, its use is not feasible in all anatomical situations that require a high-flow bypass; however it is a useful addition to the armamentarium of the neurovascular surgeon.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Reinert, Michael

ISSN:

0022-3085

ISBN:

18759591

Publisher:

American Association of Neurological Surgeons

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:02

Last Modified:

04 May 2014 23:19

Publisher DOI:

10.3171/JNS/2008/109/9/0559

PubMed ID:

18759591

Web of Science ID:

000258904400030

URI:

https://boris.unibe.ch/id/eprint/27031 (FactScience: 101349)

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