Intraoperative middle cerebral artery injury salvaged by intracranial stent placement during surgical resection of necrotizing neurosarcoidosis

Shah, D. C.; Surapaneni, Akhil; Rajagopalan, Dayal; Wang, Min; Miley, Jefferson T.; Ashour, Ramsey

doi:10.1016/j.inat.2020.101048

Cited by 1 publication

(4 citation statements)

References 13 publications

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“…10 Use of a stent retriever device for treating a thrombus after suturing has also been reported. 11 The preparation for a VI also includes to have special surgical tools available. As an example, we arrange the silicon tube for venous reconstruction, which maintains the shape of the venous wall and prevents inappropriate stitching of the far side of the venous wall (►Fig.…”

Section: Discussionmentioning

confidence: 99%

“…9 Different techniques of repair with a combination of suture and clip have been reported, such as “suture and encircling,” 5 “guiding needle method,” 6 and “place-and-clip method.” 10 Use of a stent retriever device for treating a thrombus after suturing has also been reported. 11…”

Section: Discussionmentioning

confidence: 99%

“…10 Furthermore, a case of deploying a stent-retriever device for thrombus after suturing is reported. 11 The third preparation for the VI is that we should prepare the special surgical instruments in advance.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…To the best of our knowledge, only a few cases have been favorably dealt with the injury to the intracranial, somewhat peripheral, vessels during microsurgical intracranial operation. [9][10][11] Therefore, limited information is available to learn about intracranial peripheral VI causes, details, and managing approaches. To provide these informations, we retrospectively investigated the VI cases reported at our institution to elucidate the types, causes, and implemented measures and to discuss them in the context of the current literature.…”

Section: Introductionmentioning

confidence: 99%

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Vascular Repair for Iatrogenic Injury during Microsurgical Procedures: Clinical Investigation and Review of 18 Cases at a Single Institution

Yokoya,

Hino,

Oka

2023

J Neurol Surg A Cent Eur Neurosurg

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Background: Intracranial vascular injury (VI) due to surgery is a critical complication that can lead to serious neurological deficits. To our knowledge, only a few review articles on VI during an operation have been published. We retrospectively investigated the type, cause, and measurement of VI during surgery at our institution. Materials and methods: Unexpected VI cases occurred in 18 of 2228 craniotomy procedures, including 794 clippings and 357 tumour resections. We investigated the causes and coping techniques of the VI cases, as well as their full details. Results: There were six cases of aneurysm neck tear, one case of sylvian vein injury, and one case of superior trunk perforation during direct clipping. Regarding tumour resection procedures, nine cases of arterial injury and one case of cortical vein injury were extracted. Almost all VIs were caused by carelessness or basic manipulation mistakes. We repaired all these cases with simple placement of suture threads with or without pinch clips, flow alteration using bypass techniques, and in 16 cases no neurological deficit or imaging exacerbation occurred; however, three patients were verified to have ischaemic changes on postoperative imaging. Conclusions: Most VIs were directly caused by a simple error and carelessness of an operator or assistant. Many of these injuries can be avoided if surgical procedures obey and remember a basic set of rules. However, the surgical procedure involves human work, and errors cannot be eradicated even upon maximum concentration levels. Neurosurgeons should arrange preparations for an eventual quick repair of unexpected cerebral VIs.

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Section: Discussionmentioning

confidence: 99%