title: Endoscopic radial artery harvesting for U-clip high-flow EC-IC bypass: technical report.
abstract: BACKGROUND
  Bypass and aneurysm trapping constitute a well-known surgical solution for aneurysms that are not suitable for clipping or coiling. New techniques are available that make EC-IC bypass procedures easier, safer and, possibly, less invasive. The nitinol self-closing U-Clip device (Medtronic, Inc., Minneapolis) has been designed to facilitate the interrupted suture technique by eliminating the need for suture management, knot tying, and surgical assistance.
  
  
  METHODS
  We present two consecutive U-clip bypass procedures in which the radial artery graft was harvested endoscopically.
  
  
  RESULTS
  This novel bypass technique employs endoscopy to minimise arm injury due to radial artery harvesting and self-closing U-clips to simplify the intracranial micro-anastomosis and reduce the temporary occlusion time. Angiography confirmed bypass patency in all patients.
  
  
  CONCLUSIONS
  Combined with the innovative use of U-clips, these two examples illustrate how new technologies can simplify EC-IC bypass surgery while yielding a better cosmetic and functional outcome.
authors.affiliation: Department of Neurosurgery, Fondazione Istituto Neurologico Carlo Besta, Via Celoria, 11-20133, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Ferroli
authors.forename: G
authors.initials: G
authors.lastname: Bisleri
authors.forename: A
authors.initials: A
authors.lastname: Miserocchi
authors.forename: E
authors.initials: E
authors.lastname: Albanese
authors.forename: G
authors.initials: G
authors.lastname: Polvani
authors.forename: G
authors.initials: G
authors.lastname: Broggi