title: Intracranial in situ side-to-side microvascular anastomosis: principles, operative technique, and applications.
abstract: OBJECTIVE
  Side-to-Side microvascular anastomosis is a revascularization technique used to create an artificial conduit between two similar adjacent vessels. This technique is used for microsurgical clipping of aneurysms, when indicated. It is important to study the angiographic results, both immediate and long term, along with the clinical outcomes and indications of the procedure.
  
  
  METHODS
  Fifteen patients who had this procedure over a fourteen-year period were reviewed for patency of bypass by intra-arterial digital subtraction angiography (DSA) and computed tomographic arteriograms (CTA) and their clinical outcomes were studied. The mean age of the study group was 53.4 years and mean angiographic follow up period was 14 months.
  
  
  RESULTS
  All surviving patients (14 patients) had patent anastomosis with good clinical outcomes. None of the patients developed a clinically manifested stroke due to the procedure, while one had a small asymptomatic infarct detected post operatively.
  
  
  CONCLUSIONS
  This technique is a useful and durable solution for correcting critical stenosis or complete occlusion of the vessels, while clipping intracranial aneurysms.
authors.affiliation: Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Ramanathan
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hegazy
authors.forename: Sudipta Kumar
authors.initials: SK
authors.lastname: Mukherjee
authors.forename: Laligam N
authors.initials: LN
authors.lastname: Sekhar
mesh_terms: D000328:Adult; D000368:Aged; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002548:Cerebral Revascularization / Q000295:instrumentation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D017063:Outcome Assessment, Health Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D011859:Radiography; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D013525:Surgical Instruments; D016896:Treatment Outcome