{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:49:41Z","timestamp":1772110181270,"version":"3.50.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Intracranial vascular injury (VI) due to surgery is a critical complication that can lead to serious neurologic deficits. To our knowledge, only a few review articles on VI during an operation have been published so far. We retrospectively investigated the type, cause, and measurement of VI during surgery at our institution.<\/jats:p><jats:p>\n          Methods\u2003Unexpected VI cases occurred in 18 of 2,228 craniotomy procedures, including 794 aneurysm clippings and 357 tumor resections. We investigated the causes and coping techniques of the VI cases, as well as their full details.<\/jats:p><jats:p>\n          Results\u2003There were six cases of aneurysm neck tear, one case of sylvian vein injury, and one case of superior trunk perforation during direct clipping. Regarding tumor 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 neurologic deficit or deterioration on imaging occurred; however, 3 patients were verified to have ischemic changes on postoperative imaging.<\/jats:p><jats:p>\n          Conclusions\u2003Most VIs were directly caused by a simple error and carelessness of an operator or an assistant. Many of these injuries can be avoided if a basic set of rules are followed and remembered during the surgical procedure. However, the surgical procedure involves human work, and errors cannot be eradicated even upon maximum concentration levels. Neurosurgeons should be prepared for an eventual quick repair of an unexpected cerebral VI.<\/jats:p>","DOI":"10.1055\/a-2156-5586","type":"journal-article","created":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T22:58:33Z","timestamp":1692399513000},"page":"485-491","source":"Crossref","is-referenced-by-count":1,"title":["Vascular Repair for Iatrogenic Injury during Microsurgical Procedures: Clinical Investigation and Review of 18 Cases at a Single Institution"],"prefix":"10.1055","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9050-7272","authenticated-orcid":false,"given":"Shigeomi","family":"Yokoya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiko","family":"Hino","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"ref1","first-page":"ons261","article-title":"Carotid artery injury during endoscopic endonasal skull base surgery: incidence and outcomes","volume":"73","author":"P A Gardner","year":"2013","journal-title":"Neurosurgery"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1055\/s-0037-1607314","article-title":"Injury of the carotid artery during endoscopic endonasal surgery: surveys of skull base surgeons","volume":"79","author":"N R Rowan","year":"2018","journal-title":"J Neurol Surg B Skull Base"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"938","DOI":"10.4103\/ajns.AJNS_26_18","article-title":"Cerebral bypass surgery for internal carotid artery occlusion, complex supraclinoid carotid artery aneurysm, and tumors: a report of four cases","volume":"13","author":"G Mrak","year":"2018","journal-title":"Asian J Neurosurg"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1097\/00006123-199706000-00041","article-title":"Repair of an arterial perforation of the internal carotid artery using Hemashield wrapping with aneurysm clip reinforcement: technical note","volume":"40","author":"C S Ogilvy","year":"1997","journal-title":"Neurosurgery"},{"issue":"01","key":"ref5","first-page":"218","article-title":"Repair of a tear at the base of a blister-like aneurysm with suturing and an encircling clip: technical note","volume":"50","author":"K Yanaka","year":"2002","journal-title":"Neurosurgery"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"24","DOI":"10.2335\/scs.31.24","article-title":"Repair of a tear at the base of an aneurysm during microsurgical clipping of ruptured cerebral aneurysm","volume":"31","author":"K Yanaka","year":"2003","journal-title":"Surg Cereb Stroke (Jpn)"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"E820","DOI":"10.1227\/01.NEU.0000350978.36160.7B","article-title":"Anterior cerebral artery amputation and salvage repair of internal carotid artery tear: technical case report","volume":"65","author":"S D Wait","year":"2009","journal-title":"Neurosurgery"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1007\/s10143-021-01692-1","article-title":"The surgical management of intraoperative intracranial internal carotid artery injury in open skull base surgery: a systematic review","volume":"45","author":"J Van Der 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