Self-closing nitinol U-Clips for intracranial arterial microanastomosis: A preliminary experience on seven cases

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Abstract

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.

Original languageEnglish
Pages (from-to)969-976
Number of pages8
JournalActa Neurochirurgica
Volume151
Issue number8
DOIs
Publication statusPublished - Aug 2009

Fingerprint

Surgical Instruments
Transplants
Endovascular Procedures
Indocyanine Green
Antiphospholipid Syndrome
nitinol
Spasm
Intracranial Aneurysm
Subarachnoid Hemorrhage
Aneurysm
Rupture
Thrombosis

Keywords

  • Arterial microanastomoses
  • Cerebral aneurysm
  • Intracranial bypass
  • UClip

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

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title = "Self-closing nitinol U-Clips for intracranial arterial microanastomosis: A preliminary experience on seven cases",
abstract = "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.",
keywords = "Arterial microanastomoses, Cerebral aneurysm, Intracranial bypass, UClip",
author = "P. Ferroli and F. Acerbi and G. Tringali and G. Polvani and E. Parati and G. Broggi",
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T1 - Self-closing nitinol U-Clips for intracranial arterial microanastomosis

T2 - A preliminary experience on seven cases

AU - Ferroli, P.

AU - Acerbi, F.

AU - Tringali, G.

AU - Polvani, G.

AU - Parati, E.

AU - Broggi, G.

PY - 2009/8

Y1 - 2009/8

N2 - 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.

AB - 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.

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