title: Bending the curve:  preoperative determination of bypass graft length and trajectory with curved planar reformatted computed tomography angiography:  technical note.
abstract: BACKGROUND
  Cerebral revascularization continues to be an important technique for the treatment of cerebrovascular and vaso-occlusive diseases, and determination of appropriate graft sources and recipients is paramount to the success of the procedure. A tension-free anastomosis requires that harvested grafts be of an appropriate length to avoid complications. Volume-rendered contrast-enhanced computed tomography data sets may be useful in determining the desired length and path of the bypass graft and in the evaluation of appropriate recipient vessels. Curved planar reformation techniques may allow these properties to be determined in a novel, inexpensive, and efficient manner.
  
  
  METHODS
  A 63-year-old patient with a left hemispheric perfusion deficit and without an external carotid artery was in need of high-flow cerebral revascularization. A radial artery graft spanning from the vertebral artery to the middle cerebral artery was proposed. Preoperative determination of graft length necessary and most efficient subcutaneous placement was desired. A standard computed tomography angiogram of the head and neck was obtained and imported into a computer workstation with curved planar reformatting capabilities.
  
  
  CONCLUSIONS
  Curved planar reformation technique can be used for preoperative planning of cerebral bypass procedures and is a novel, inexpensive, and efficient means of determining the desired length and path of the bypass graft and in the evaluation of appropriate recipient vessels.
authors.affiliation: Department of Radiology , UT Southwestern Medical Center, Dallas, Texas 75390, USA.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Markham
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Eddleman
authors.forename: David
authors.initials: D
authors.lastname: Uhrbrock
authors.forename: Babu G
authors.initials: BG
authors.lastname: Welch
mesh_terms: D002533:Cerebral Angiography / Q000379:methods*; D002548:Cerebral Revascularization / Q000379:methods*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012086:Reoperation / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*