2024-03-29T15:14:22Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00014811
2023-11-16T06:01:12Z
499:508:509:1403
AIR VENT OF VEIN GRAFT IN EXTRACRANIAL-INTRACRANIAL BYPASS SURGERY
OYAMA, HIROFUMI
KITO, AKIRA
MAKI, HIDEKI
HATTORI, KENICHI
NODA, TOMOYUKI
WADA, KENTARO
open access
Air vent
Vein graft
EC-IC bypass
Saphenous vein
Accessory branch
Revascularization with a vein graft is a mandatory method for treatment of dissecting or pseudoaneurysms of the internal carotid artery. We report the necessity for an air vent from the vein graft and explain its use in our two cases. In Case 1, we searched for a great saphenous vein around its junction with a femoral vein during the harvest of vein graft. An accessory branch of that great saphenous vein was also found around the junctional region with a femoral vein, and was temporarily ligated. At first, anastomosis was completed on both the distal and proximal sides. After the proximal side of a vein graft was opened and the ligation of the branch was loosened, an air vent could be made through the branch of the vein graft. Multiple air bubbles and a large quantity of white microemboli were discharged through this branch. The postoperative course was uneventful. In Case 2, the air vent was omitted to shorten ischemia. During the opening of the vein graft, the migrated air was observed to move to the middle cerebral artery. A computed tomography scan demonstrated that brain infarction and dysarthria occurred postoperatively. The air vent of the vein graft is essential in extracranial-intracranial bypass surgery, because the air bubbles or microthrombi are easily trapped around the valve and cause cerebral infarction. An air vent can be easily made if the branch of a vein graft exists in the outflow pathway, because intraluminal air or thrombus can be washed out through the branch at the final stage of surgery.
Nagoya University School of Medicine
2012-08
eng
departmental bulletin paper
VoR
https://doi.org/10.18999/nagjms.74.3-4.339
http://hdl.handle.net/2237/16744
https://nagoya.repo.nii.ac.jp/records/14811
10.18999/nagjms.74.3-4.339
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/7434/7434.html
2186-3326
0027-7622
Nagoya Journal of Medical Science
74
3-4
339
345
https://nagoya.repo.nii.ac.jp/record/14811/files/12_Oyama.pdf
application/pdf
827.5 kB
2018-02-20