Running-to-Interrupted Microsuture Technique for Vascular Bypass

The ideal suturing technique for microvascular anastomosis for neurosurgical bypass procedures remains a point of debate. Simple interrupted sutures are thought to possess higher long-term patency but require more time to place as compared to running sutures.

To optimize the efficiency of microvascular anastomosis and limit brain ischemia time.

The running-to-interrupted microsuture technique, a modification of the previously published spiral anastomosis, is described wherein loosely thrown running sutures are placed between 2 opposed anchor stitches. The loops are then serially cut and tied, resulting in efficiently placed interrupted stitches. This process is repeated on the opposite side to complete the anastomosis.

The running-to-interrupted microsuture technique is quickly learned, limits unnecessary microsurgical movements, and is employed by the senior author for a multitude of cerebral arterial bypass procedures.

This technical improvement can be adapted by any neurovascular surgeon to optimize microsurgical efficiency and limit anastomosis-related brain ischemia times.