The clinical utility of the Kopitnik arteriovenous malformation microclip during STA-MCA bypass surgery.
OBJECTIVE
Yasagil temporary clips have been widely used in extracranial-intracranial (EC-IC) arterial bypass surgery. However, the extremely delicate vessels involved often require the application of finer clips. We report on the use of the Kopitnik arteriovenous malformation (AVM) microclip system for superficial temporal artery-middle cerebral artery (STA-MCA) bypass.


METHODS
Kopitnik AVM microclips are new mechanical devices that are used during AVM surgery. They exert a pre-defined closing force of 50-70 g, and also feature a special, pyramid-shaped structure stamped on inner surfaces of the blades. These characteristics avoid vascular intimal injury and provide a secure grip. We prospectively studied their use in 15 patients requiring STA-MCA anastomosis.


RESULTS
Clinical results were excellent and there were no new ischemic events during 6-months' follow-up.


CONCLUSIONS
Kopitnik AVM microclips have several advantages; they have small and variously sized clip blades (2, 3, 4 and 5 mm), and the small clip head allows the operator an excellent view of the pathology and clip status. The Kopitnik AVM microclip appears to be clinically effective and safe for EC-IC bypass surgery, especially when smaller vessels are involved.
Joo
Sung Pil
SP
Department of Neurosurgery, Chonnam National University Hospital and Medical School, Dong-Gu, Gwangju 501-757, Republic of Korea.
Kim
Tae Sun
TS
Seo
Bo Ra
BR
Lee
Jung Kil
JK
Kim
Jae Hyoo
JH
Kim
Soo Han
SH
Kim
Joon Tae
JT
Park
Man Seok
MS
Cho
Ki Hyun
KH
D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply; D016893:Carotid Stenosis / Q000473:pathology / Q000601:surgery*; D002548:Cerebral Revascularization / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D020244:Infarction, Middle Cerebral Artery / Q000473:pathology / Q000601:surgery*; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000033:anatomy & histology / Q000601:surgery; D009072:Moyamoya Disease / Q000473:pathology / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D013525:Surgical Instruments / Q000592:standards* / Q000706:statistics & numerical data; D013699:Temporal Arteries / Q000033:anatomy & histology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult