Three-Vessel Anastomosis for Direct Bihemispheric Cerebral Revascularization.

摘要: Background In rare, complex cerebrovascular pathologies, patients may benefit from simultaneous revascularization of multiple arterial territories. Traditional strategies for these situations include the use more than 1 interposition graft, microvascular anastomoses, vessel reimplantations, and staged procedures. Objective To improve upon traditional by describing a novel 3-vessel anastomosis. This technique combines side-to-side an end-to-side anastomoses to facilitate direct 2 territories in single procedure, with donor vessel. Methods We present illustrative case moyamoya angiopathy which anastomosis was performed interhemispheric fissure simultaneously directly revascularize bilateral anterior cerebral artery (ACA) A detailed step-by-step depiction is provided. presented case, combined radial fascial flow-through free flap, allowing additional indirect revascularization. Results Technical execution uncomplicated. The patency providing ACA territory demonstrated intra- postoperatively. Conclusion With this report, we demonstrate technical feasibility single-stage approach techniques has benefits over techniques, as it not deconstructive, requires only craniotomy does require lengthy recipient dissection.