Revascularization of the Anterior Inferior Cerebellar Artery Using Extracranial and Intracranial Donors: A Morphometric Cadaveric Study

Vilalta, Àlex De; Kournoutas, Ioannis; Ojeda, Pablo López; Canals, Andreu Gabarrós; Vigo, Vera; Rutledge, Caleb; Chae, Ricky; Abla, Adib A.; Rubio, Roberto Rodriguez

doi:10.1016/j.wneu.2019.03.260

Cited by 9 publications

(4 citation statements)

References 28 publications

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“…Hence, for surgically managed a2 aneurysms, donor vessels should be prepared for possible bypass. 6 In strictly selected cases, in situ suturing is a reasonable option. By partial removal and suturing of the aneurysm wall, the complexity of vascular bypass can be avoided.…”

Section: Discussionmentioning

confidence: 99%

“…5 Hence, in order to preserve the parent AICA distal to the aneurysm, an extracranial–intracranial bypass through open surgery is the main choice. 6 , 7 In this report, we present an interesting case of a post-meatal segment AICA aneurysm. With partial removal and interrupted in situ suturing of the aneurysm wall, the parent artery was successfully preserved.…”

Section: Introductionmentioning

confidence: 92%

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In situ suturing of a post-meatal segment of the anterior inferior cerebellar artery dissected by an aneurysm: A technical note

Hou

Guo

et al. 2020

Neuroradiol J

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Aneurysms originating along the peripheral portion of the anterior inferior cerebellar artery (AICA) are rare entities. As a result of the small diameter of the AICA, it is very challenging to preserve the parent artery during endovascular treatment for a peripheral AICA aneurysm. In this report, we present a rare case of aneurysm in the a2 segment of the right AICA. During surgery, the aneurysm was found to be a dissecting aneurysm. As the tissue of the aneurysm neck had a similar thickness to that of the adjacent normal vessel, interrupted suturing of the vessel was performed after partial removal and trimming of the aneurysm wall. The patient experienced an uneventful postoperative recovery. No other neurological deficit was noted. Magnetic resonance imaging three days after surgery revealed no acute ischaemia in the brainstem and cerebellum. Catheter angiography nine months later showed no recurrence of the aneurysm or stenosis of the AICA. The a2 segment of the AICA runs tortuously along the subarachnoid space of the cerebellopontine angle, which permits higher vascular mobility. In selected cases, in situ suturing or re-anastomosis could be considered for a2 segment aneurysms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

In situ suturing of a post-meatal segment of the anterior inferior cerebellar artery dissected by an aneurysm: A technical note

Hou

Guo

et al. 2020

Neuroradiol J

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“…End-to-side microvascular anastomosis is one of the most commonly used anastomotic configurations in cerebral revascularization surgeries and connects the end of the donor artery with the side of the recipient artery through an anastomosis (1)(2)(3)(4)(5). Theoretically, the ideal anastomosis should be performed between two perfectly matched vessels under little or no tension situations; however, nonideal anastomosis, such as mismatched vessels or some tension between donor and recipient vessels, is commonly encountered in real operations (6,7).…”

Section: Introductionmentioning

confidence: 99%

Three types of end-to-side microvascular anastomosis training models using rat common iliac arteries

et al. 2023

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Background: Instead of only practicing these perfectly matched end-to-side anastomoses in microsurgical laboratories, we must learn how to perform these so-called “imperfect” end-to-side anastomoses in the laboratory.MethodsThree types of end-to-side microvascular anastomoses using the rat common iliac artery (CIA), one with the proximal end of the CIA to the contralateral side of the CIA, another with the distal end of the CIA to the contralateral side of the CIA, and the third with the distal end of the CIA to the ipsilateral side of the common iliac vein (CIV), were presented to simulate different end-to-side anastomosis situations in a microsurgical laboratory. Diameters of CIA and CIV, distances between temporary clips, the length of arteriotomy or venotomy, and the distribution of stitches were recorded. The patency rates were evaluated immediately after the anastomosis was completed and 30 min later. After animal euthanasia, the donor vessel was cut close to the anastomotic site, and the orifice size and intimal attachment were evaluated by inspecting them through inside the vessel.ResultsThe diameters of the CIA and CIV were 0.8–1.2 mm and 1.2–1.5 mm, respectively. The end-to-side microvascular anastomosis arteriotomy or venotomy is approximately 2.00–2.50 mm, the distance between the aneurysm clips on the recipient CIA or CIV is approximately 4.00–7.00 mm, and the distance between the corner of the arteriotomy or venotomy and the temporary aneurysm clip was 1.00–3.00 mm. Three types of end-to-side anastomoses using the CIA were successfully performed, and 100% patency rates were achieved immediately and 30 min postoperatively. Good distribution of stitches, wide orifice, and intimal attachment were recorded in the study in all groups.ConclusionsThree types of end-to-side anastomoses using rat CIAs could be efficiently used to mimic three different anastomotic situations.

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“…3,4 Extracranial-intracranial or intracranial-intracranial anastomosis is another good option after removing or trapping the aneurysm. 5,6 However, for many neurosurgical practitioners, open surgery is often aggressive, complicated, and challenging.…”

Section: Introductionmentioning

confidence: 99%

Endovascular treatment of anterior inferior cerebellar artery trunk aneurysms

Hou

2021

Interv Neuroradiol

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Background The anterior inferior cerebellar artery (AICA) is a very slender and anatomically variable artery that gives off many important perforating arteries that feed the brainstem and nerve-related arteries that feed the inner ear and labyrinth. AICA trunk aneurysms are rare entities that are also difficult to manage. At present, endovascular treatment (EVT) is the preferred choice; however, the understanding of EVT for AICA trunk aneurysms is limited. Methods In this article, we present a literature review on EVT for AICA trunk aneurysms. To promote understanding, we would also provide some illustrative educational cases of our institute. Results Aneurysms along the AICA trunk can occur alone (isolated AICA aneurysm) or secondary to cerebrovascular shunts (flow-related AICA aneurysm). According to their anatomical location, they can also be divided into proximal and distal types. At present, EVT is the mainstream treatment, mainly including selective coiling with parent artery preservation and parent artery occlusion. Both coils and liquid embolization materials can be used. Conclusions For AICA trunk aneurysms, EVT is a reasonable choice and should be based on the specific anatomical location, pathology, and collateral circulation. However, there is still controversy as to the specific type of treatment that should be chosen.

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Revascularization of the Anterior Inferior Cerebellar Artery Using Extracranial and Intracranial Donors: A Morphometric Cadaveric Study

Cited by 9 publications

References 28 publications

In situ suturing of a post-meatal segment of the anterior inferior cerebellar artery dissected by an aneurysm: A technical note

In situ suturing of a post-meatal segment of the anterior inferior cerebellar artery dissected by an aneurysm: A technical note

Three types of end-to-side microvascular anastomosis training models using rat common iliac arteries

Endovascular treatment of anterior inferior cerebellar artery trunk aneurysms

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