title: Higher magnification microsurgical repair of donor artery dissection in superficial temporal artery to middle cerebral artery anastomosis--technical note.
abstract: Donor artery dissection is a known cause of technical failure in microvascular anastomosis. A method for detection and direct repair of donor artery dissection before superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis is described using a high magnification operating microscope (maximum 50.4× magnification). Before STA-MCA anastomosis, the stump of the STA is stained using methylrosaniline chloride (pyoctaninum blue) and is observed under higher magnifications. Microsurgical suturing of the arterial dissection is performed before the anastomosis procedure under the high magnification microscope. This method was used in two patients with symptomatic hemodynamic cerebrovascular occlusive disease. Postoperative angiography revealed good patency and no complications occurred. This method may be useful for detection and direct repair of arterial dissection in small vessel walls before STA-MCA anastomosis.
authors.affiliation: Department of Neurosurgery, Stroke Center, Saiseikai Toyama Hospital, Toyama, Japan. sanataka@pk.ctt.ne.jp
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Matsumura
authors.forename: Takashi
authors.initials: T
authors.lastname: Shibata
authors.forename: Hironaga
authors.initials: H
authors.lastname: Kamiyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tomita
authors.forename: Soushi
authors.initials: S
authors.lastname: Okamoto
authors.forename: Michiya
authors.initials: M
authors.lastname: Kubo
authors.forename: Yukio
authors.initials: Y
authors.lastname: Horie
mesh_terms: D000784:Aortic Dissection / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D002548:Cerebral Revascularization / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011859:Radiography; D012086:Reoperation / Q000379:methods*; D013699:Temporal Arteries / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome