Preventing Spontaneous Thrombosis of Experimental Sidewall Aneurysms: The Oblique Cut
Yoshikazu Yoshinoa,
Yasunari Niimia,
Joon K. Songa,
Shinya Khoyamaa,
Yong Sam Shina and
Alejandro Berensteina
a From the Center for Endovascular Surgery, Beth Israel Hyman-Newman Institute for Neurology and Neurosurgery, Roosevelt Hospital, New York, NY
View larger version (15K):
[in a new window]
|
FIG 1. Schematic drawing of the oblique-cut method of constructing a sidewall aneurysm.
The aneurysm neck segment of venous pouch harvested from the EJV was cut approximately 45° angle to the aneurysm long axis (arrowhead). An elliptical arteriotomy, approximately 6 mm long, is created on the lateral end of the right CCA. The neck segment of the pouch is then sutured along the edges of the arteriotomy by using 6–0 Proline sutures, resulting in a berry-shaped sidewall aneurysm.
| |
View larger version (129K):
[in a new window]
|
FIG 2. Intraoperative view and DSA image of a sidewall aneurysm constructed obliquely to parent artery. The aneurysm remained patent on 30-day follow-up angiogram (A, C, arrow). Intraoperative view and DSA image of a sidewall aneurysm constructed conventionally perpendicular to the long axis of the parent vessel. The aneurysm was thrombosed 27 days after construction. (B, D, arrow).
| |
AJNR - American Journal of Neuroradiology