{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T06:08:25Z","timestamp":1761718105857},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:p>Cerebral bypass procedures in the posterior circulation are difficult to perform and are considered to be high-risk surgery. Venous grafts, like that formed using the saphenous vein (SV), are simple to obtain without posing a high risk of morbidity. The main disadvantage of these high-flow grafts is the mismatch in vessel diameter between donor and recipient vessels in the posterior circulation.<\/jats:p>\n<jats:p>The authors performed a retrospective case study based of data from intraoperative video, patient charts, axial images, and cerebral angiograms.<\/jats:p>\n<jats:p>They treated a 66-year-old man who presented with a giant aneurysm of the vertebrobasilar junction and another large aneurysm of the basilar tip. They chose to create a vertebral artery (VA)\u2013superior cerebellar artery anastomosis with a tapered-down SV graft. It was necessary to reengineer the SV graft to include a gentle taper that would allow for this anastomosis. The vein was incised for a distance of 2.5 cm. A triangular section of the vein, 2 mm at the base and 20 mm high, was then excised from the opened end of the SV. The 2.5-cm-long venotomy was then closed with interrupted 9-0 Prolene sutures creating a gentle taper to the vein down to ~ 2.5 mm in diameter. Thereafter, the authors created a standard end-to-side anastomosis of the VA to the SV with 8-0 Prolene. Postoperatively both VAs were obliterated with coils just proximal to the vertebrobasilar aneurysm. The bypass was patent; after a prolonged stay in the intensive care unit, the patient recovered gradually.<\/jats:p>\n<jats:p>This technique of linear venotomy along the distal 2.5 cm of the vein and subsequent tapering down of the diameter diminishes the circumference of the distal end of the graft, facilitating bypass to smaller vessels. This is a novel and feasible technique to eliminate vessel mismatch in cerebral bypass procedures in the difficult accessible vessels of the posterior circulation.<\/jats:p>","DOI":"10.3171\/2009.9.jns09367","type":"journal-article","created":{"date-parts":[[2009,9,25]],"date-time":"2009-09-25T18:17:18Z","timestamp":1253902638000},"page":"1227-1231","source":"Crossref","is-referenced-by-count":5,"title":["Novel technique to improve vessel mismatch when using saphenous vein bypass grafts for intracranial revascularization procedures"],"prefix":"10.3171","volume":"112","author":[{"given":"Franz","family":"Marhold","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Landesklinikum St. P\u00f6lten, Austria; and"},{"name":"Department of Neurosurgery, West Virginia University School of Medicine, Morgantown, West Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles L.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West Virginia University School of Medicine, Morgantown, West Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-1121227","series-title":"Surg Neurol","first-page":"565","article-title":"Endoscopic saphenous vein graft harvest for extracranial-bypass procedures","volume":"63","author":"Alexander","year":"2005"},{"key":"b2-1121227","series-title":"J Neurosurg","first-page":"795","article-title":"Reversed-flow saphenous vein grafts for cerebral revascularization","volume":"87","author":"David","year":"1997"},{"key":"b3-1121227","series-title":"N Engl J Med","first-page":"1191","article-title":"Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial","volume":"313","author":"The EC\/IC Bypass Study Group","year":"1985"},{"key":"b4-1121227","series-title":"Neurosurgery","first-page":"1036","article-title":"Bypass grafting and revascularization in the management of posterior circulation aneurysms","volume":"55","author":"Evans","year":"2004"},{"key":"b5-1121227","series-title":"Neurosurgery","first-page":"138","article-title":"Treatment of giant intracranial aneurysms with saphenous vein extracranial-to-intracranial bypass grafting: indications, operative technique and results in 29 patients","volume":"51","author":"Jafar","year":"2002"},{"key":"b6-1121227","series-title":"Neurosurg Clin N Am","first-page":"541","article-title":"The role of cerebral revascularization in patients with intracranial aneurysms","volume":"12","author":"Javedan","year":"2001"},{"key":"b7-1121227","series-title":"Neurosurgery","first-page":"83","article-title":"Revascularization and aneurysm surgery: current techniques, indications and outcome","volume":"38","author":"Lawton","year":"1996"},{"key":"b8-1121227","series-title":"J Med Dent Sci","first-page":"101","article-title":"Hand circulation after radial artery harvest for coronary artery bypass grafting","volume":"52","author":"Manabe","year":"2005"},{"key":"b9-1121227","series-title":"Acta Otolaryngol","first-page":"526","article-title":"A modified technique for bypass of the external carotid artery to the proximal posterior cerebral artery: an anatomical and technical study","volume":"126","author":"Ozturk","year":"2006"},{"key":"b10-1121227","series-title":"Surg Neurol","first-page":"285","article-title":"Revascularizing the upper basilar circulation with saphenous vein grafts: operative technique and lessons learned","volume":"66","author":"Russell","year":"2006"},{"key":"b11-1121227","series-title":"Neurosurgery","first-page":"646","article-title":"Cerebral revascularization using radial artery grafts for the treatment of complex intracranial aneurysms: techniques and outcomes for 17 patients","volume":"49","author":"Sekhar","year":"2001"},{"key":"b12-1121227","series-title":"Neurol Res","first-page":"345","article-title":"The role of EC-IC in the treatment of giant intracranial aneurysms","volume":"2","author":"Spetzler","year":"1980"},{"key":"b13-1121227","series-title":"J Neurosurg","first-page":"22","article-title":"Elective extracranial-intracranial arterial bypass in the treatment of inoperable giant aneurysms of the internal carotid artery","volume":"53","author":"Spetzler","year":"1980"},{"key":"b14-1121227","series-title":"J Neurosurg","first-page":"439","article-title":"Saphenous vein bypass grafts for giant aneurysms and intracranial occlusive disease","volume":"65","author":"Sundt","year":"1986"},{"key":"b15-1121227","series-title":"Neurosurgery","first-page":"761","article-title":"Long-term graft patency rates and clinical outcomes after revascularization for symptomatic traumatic internal carotid artery dissection","volume":"43","author":"Vishteh","year":"1998"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/112\/6\/article-p1227.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/112\/6\/article-p1227.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/112\/6\/article-p1227.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T08:14:27Z","timestamp":1679904867000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/112\/6\/article-p1227.xml"}},"subtitle":["Technical note"],"short-title":[],"issued":{"date-parts":[[2010,6]]},"references-count":15,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2009.9.jns09367","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,6]]}}}