End-to-side anastomoses in small arteries with partial lateral clipping. An experimental study

Area of Science:

• Neurosurgery
• Vascular Surgery
• Surgical Innovation

Background:

• Total therapeutic occlusion of cranial arteries is a significant challenge in neurosurgery, neurology, neuroradiology, and neuroanesthesia.
• Cerebral revascularization necessitates temporary occlusion of cranial arteries, posing risks to patients.
• Current cerebrovascular bypass procedures have theoretical limitations.

Purpose of the Study:

• To investigate the feasibility of end-to-side anastomosis with partial lateral clipping.
• To assess the ability to maintain blood flow in the target vessel during anastomosis.
• To compare this novel technique with existing cerebrovascular bypass methods.

Main Methods:

• End-to-side anastomoses were performed using partial lateral clipping in 20 cadaver arteries.
• The technique was tested on one rat common carotid artery.
• Results were theoretically compared with current cerebrovascular bypass procedures.

Main Results:

• All performed anastomoses remained open.
• The technique demonstrated experimental possibility for maintaining blood flow during anastomosis.
• Available aneurysm clips are suitable for larger vessels (> 2.5 mm).

Conclusions:

• End-to-side anastomosis with partial lateral clipping is experimentally feasible and allows for maintenance of blood flow.
• Specialized clips for this technique are not yet commercially available, though existing aneurysm clips may suffice for larger vessels.
• Further investigation into the clinical implications of this technique is warranted.