Double reimplantation technique to reconstruct arterial bifurcations with giant aneurysms.

摘要: OBJECTIVE: To introduce the double implantation technique, a variation of standard radial artery or saphenous vein bypass that can be used to reconstruct arterial bifurcations in management giant aneurysms with complex branch arteries. METHODS: This technique was applied two patients aneurysms. A 74-year-old woman presented ruptured thrombotic middle cerebral aneurysm, and 24-year-old man an enlarging infectious aneurysm distal anterior (ACA). RESULTS: In first case, graft anastomosed end-to-end external carotid artery. The temporal M2 trunk disconnected from reimplanted onto end-to-side anastomosis. frontal trunk, trapped. Similarly, second connected proximal ACA (anterior internal artery) pericallosal artery, reimplantation callosomarginal graft. occluded proximally clip. CONCLUSION: combination reimplantations donor (3 anastomoses overall) reconstructs bifurcation enables exclusion aneurysm. Ischemia times are minimized by completing anastomosis first, successively reimplanting efferent trunks distally, restoring perfusion arteries while other performed. may indicated when critical require revascularization, conventional diminutive, has ruptured, intraluminal thrombus requires debulking.