フナツ　タカユキ   Funatsu Takayuki   船津　尭之    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	日本語
査読の有無	査読あり
表題	[Application of Silicone Rubber Stents in Intracranial Arterial Microanastomosis for Vessels with Intimal Dissection:A Technical Note].
掲載誌名	正式名：No shinkei geka. Neurological surgery 略　 称：No Shinkei Geka ISSNコード：(0301-2603)0301-2603(Linking)
掲載区分	国内
巻・号・頁	43(10),907-12頁
著者・共著者	Funatsu Takayuki, Kawashima Akitsugu, Mochizuki Yuichi, Kikuta Yoshichika, Imanaka Kousuke, Okada Yoshikazu
発行年月	2015/10
概要	Intracranial arterial microanastomosis remains an important neurosurgical technique. Intimal dissection of donor or recipient arteries can cause bypass failure. We used a silicone rubber stent while performing arterial microanastomoses, and achieved an excellent postoperative patency rate. In this study, we evaluated the efficacy of the stent in cases of extensive intimal dissection. In 5 cases involving extensive intimal dissection of vessels out of a total of 856 microanastomoses that were performed between November 2000 and August 2014, we placed a silicone rubber stent in the lumen of the recipient artery for donor to recipient suturing. Surgery was performed in 3 cases of cerebrovascular atherosclerotic disease and in 2 cases requiring cerebral revascularization for the treatment of aneurysm recurrence. In one of the 5 cases in which arterial microanastomosis was performed in the spasm period after subarachnoid hemorrhage, a patent anastomosis could not be confirmed. We observed the following advantages of silicone stent use: clear visualization of the orifice created in the vessel, avoidance of suturing or damaging the contralateral side vessel edges, and maintenance of the shape of the anastomosed vessel segment. These advantages made it easier to visualize the intima and to achieve fixation by using tacking sutures.
DOI	10.11477/mf.1436203146
PMID	26435370