Extended superciliary approach for middle cerebral artery embolectomy after unsuccessful endovascular recanalization therapy: technical note

Neurosurgery
Jaechan ParkYongsun Kim

Abstract

Although an intra-arterial mechanical embolectomy extends the therapeutic time window for restoration of the cerebral blood flow, its suboptimal recanalization rate also necessitates a salvage procedure if the patient is still within the therapeutic time window. As such, a surgical embolectomy can be performed in a rapid and less invasive manner for an acute middle cerebral artery (MCA) occlusion. The technical details of this procedure are discussed and demonstrated. Four patients with an acute MCA occlusion were treated using a novel surgical embolectomy technique after unsuccessful intra-arterial mechanical recanalization therapy. Unique to the proposed surgical technique are a laterally extended superciliary approach, small (3-mm) arteriotomy, and closure of the arteriotomy using an aneurysm clip after removal of the intravascular embolus. Occluded MCAs were successfully recanalized using the present technique, and the operative time from skin incision to recanalization was 1 to 1.5 hours in each patient. One to 3 arteriotomies were made in each patient. Six of the 8 arteriotomies in the present series were closed using an aneurysm clip, whereas the other 2 arteriotomies were repaired using microsutures. Postoperative angio...Continue Reading

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Citations

May 2, 2013·Journal of Neurointerventional Surgery·Jin Sue JeonHeung Cheol Kim
May 11, 2013·British Journal of Neurosurgery·Tomohiro InoueNobuhito Saito
Nov 19, 2014·Journal of Neurosurgery·Gregory J Zipfel
Jul 16, 2014·Surgical Neurology International·Makoto KatsunoMasaaki Hashimoto
Jul 6, 2014·Surgical Neurology International·Noriaki MinamiAkio Morita
Jul 13, 2019·Journal of Korean Neurosurgical Society·Jaechan Park
May 13, 2015·Neurosurgical Review·Tomohiro InoueNobuhito Saito

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