Effect of newly developed scissors-attached micro-forceps on the recipient clamp time and occurrence of anastomotic site infarction after bypass surgery for moyamoya disease
IntroductionThis study aimed to examine the effect of newly developed scissors-attached micro-forceps in superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis for moyamoya disease (MMD).Materials and methodsOf 179 consecutive STA-MCA anastomoses on 95 hemispheres of 71 MMD pati...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1269400/full |
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| author | Munetaka Yomo Ryuhei Kitai Hiroyuki Tada Makoto Isozaki Yoshifumi Higashino Ken Matsuda Takahiro Yamauchi Ayumi Akazawa Satoshi Kawajri Mizuki Oiwa Shintaro Yamada Tadahiro Tsubota Akifumi Watanabe Hidehiko Okazawa Yasushi Kiyono Hidetaka Arishma Kenichiro Kikuta Kenichiro Kikuta |
| author_facet | Munetaka Yomo Ryuhei Kitai Hiroyuki Tada Makoto Isozaki Yoshifumi Higashino Ken Matsuda Takahiro Yamauchi Ayumi Akazawa Satoshi Kawajri Mizuki Oiwa Shintaro Yamada Tadahiro Tsubota Akifumi Watanabe Hidehiko Okazawa Yasushi Kiyono Hidetaka Arishma Kenichiro Kikuta Kenichiro Kikuta |
| author_sort | Munetaka Yomo |
| collection | DOAJ |
| description | IntroductionThis study aimed to examine the effect of newly developed scissors-attached micro-forceps in superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis for moyamoya disease (MMD).Materials and methodsOf 179 consecutive STA-MCA anastomoses on 95 hemispheres of 71 MMD patients at the University of Fukui Hospital between 2009 and 2023, 49 anastomoses on 26 hemispheres of 21 patients were enrolled in this retrospective cohort clinical trial intraoperative indocyanine green video-angiography did not demonstrate bypass patency in three anastomoses in two patients who were excluded. Twenty-one anastomosis in 19 hemispheres of 16 patients were performed using the conventional micro-forceps (conventional group, CG), and 25 anastomoses in 22 hemispheres of 19 patients were performed using scissors-attached micro-forceps (scissors group, SG). A small infarction near the anastomotic site detected using postoperative diffusion-weighted imaging was defined as anastomotic site infarction (ASI). Factors affecting the occurrence of ASI were examined by univariate, logistic regression, and receiver operating curve (ROC) analysis.ResultsThere were no significant differences in clinical parameters such as age, sex, number of sacrificed branches, number of sacrificed large branches, and number of sutures between the CG and SG. However, the clamp time and occurrence of ASI were significantly lower in the SG than in the CG. Logistic regression analysis revealed that the clamp time was the only significant factor predicting the occurrence of ASI. A receiver operating curve analysis also revealed that the clamp time significantly predicted the occurrence of ASI (area under the curve, 0.875; cutoff value, 33.2 min).ConclusionThe newly developed scissors-attached micro-forceps could significantly reduce the clamp time and occurrence of ASI in STA-MCA anastomosis for MMD. |
| first_indexed | 2024-03-11T19:41:47Z |
| format | Article |
| id | doaj.art-b70154ba9b1a46ad819ca0e4bdd4b35e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-11T19:41:47Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-b70154ba9b1a46ad819ca0e4bdd4b35e2023-10-06T08:26:23ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-10-011410.3389/fneur.2023.12694001269400Effect of newly developed scissors-attached micro-forceps on the recipient clamp time and occurrence of anastomotic site infarction after bypass surgery for moyamoya diseaseMunetaka Yomo0Ryuhei Kitai1Hiroyuki Tada2Makoto Isozaki3Yoshifumi Higashino4Ken Matsuda5Takahiro Yamauchi6Ayumi Akazawa7Satoshi Kawajri8Mizuki Oiwa9Shintaro Yamada10Tadahiro Tsubota11Akifumi Watanabe12Hidehiko Okazawa13Yasushi Kiyono14Hidetaka Arishma15Kenichiro Kikuta16Kenichiro Kikuta17Division of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDepartment of Neurosurgery, Kaga Medical Center, Kaga, JapanTechnology Development Section, Charmant Co., Ltd., Sabae, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanBiomedical Imaging Research Center, University of Fukui, Fukui, JapanBiomedical Imaging Research Center, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanDivision of Medicine, Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, JapanLife Science Innovation Center, University of Fukui, Fukui, JapanIntroductionThis study aimed to examine the effect of newly developed scissors-attached micro-forceps in superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis for moyamoya disease (MMD).Materials and methodsOf 179 consecutive STA-MCA anastomoses on 95 hemispheres of 71 MMD patients at the University of Fukui Hospital between 2009 and 2023, 49 anastomoses on 26 hemispheres of 21 patients were enrolled in this retrospective cohort clinical trial intraoperative indocyanine green video-angiography did not demonstrate bypass patency in three anastomoses in two patients who were excluded. Twenty-one anastomosis in 19 hemispheres of 16 patients were performed using the conventional micro-forceps (conventional group, CG), and 25 anastomoses in 22 hemispheres of 19 patients were performed using scissors-attached micro-forceps (scissors group, SG). A small infarction near the anastomotic site detected using postoperative diffusion-weighted imaging was defined as anastomotic site infarction (ASI). Factors affecting the occurrence of ASI were examined by univariate, logistic regression, and receiver operating curve (ROC) analysis.ResultsThere were no significant differences in clinical parameters such as age, sex, number of sacrificed branches, number of sacrificed large branches, and number of sutures between the CG and SG. However, the clamp time and occurrence of ASI were significantly lower in the SG than in the CG. Logistic regression analysis revealed that the clamp time was the only significant factor predicting the occurrence of ASI. A receiver operating curve analysis also revealed that the clamp time significantly predicted the occurrence of ASI (area under the curve, 0.875; cutoff value, 33.2 min).ConclusionThe newly developed scissors-attached micro-forceps could significantly reduce the clamp time and occurrence of ASI in STA-MCA anastomosis for MMD.https://www.frontiersin.org/articles/10.3389/fneur.2023.1269400/fullmoyamoya diseaseSTA-MCA anastomosisclamp timeischemiaanastomotic sitemicro-forceps |
| spellingShingle | Munetaka Yomo Ryuhei Kitai Hiroyuki Tada Makoto Isozaki Yoshifumi Higashino Ken Matsuda Takahiro Yamauchi Ayumi Akazawa Satoshi Kawajri Mizuki Oiwa Shintaro Yamada Tadahiro Tsubota Akifumi Watanabe Hidehiko Okazawa Yasushi Kiyono Hidetaka Arishma Kenichiro Kikuta Kenichiro Kikuta Effect of newly developed scissors-attached micro-forceps on the recipient clamp time and occurrence of anastomotic site infarction after bypass surgery for moyamoya disease Frontiers in Neurology moyamoya disease STA-MCA anastomosis clamp time ischemia anastomotic site micro-forceps |
| title | Effect of newly developed scissors-attached micro-forceps on the recipient clamp time and occurrence of anastomotic site infarction after bypass surgery for moyamoya disease |
| title_full | Effect of newly developed scissors-attached micro-forceps on the recipient clamp time and occurrence of anastomotic site infarction after bypass surgery for moyamoya disease |
| title_fullStr | Effect of newly developed scissors-attached micro-forceps on the recipient clamp time and occurrence of anastomotic site infarction after bypass surgery for moyamoya disease |
| title_full_unstemmed | Effect of newly developed scissors-attached micro-forceps on the recipient clamp time and occurrence of anastomotic site infarction after bypass surgery for moyamoya disease |
| title_short | Effect of newly developed scissors-attached micro-forceps on the recipient clamp time and occurrence of anastomotic site infarction after bypass surgery for moyamoya disease |
| title_sort | effect of newly developed scissors attached micro forceps on the recipient clamp time and occurrence of anastomotic site infarction after bypass surgery for moyamoya disease |
| topic | moyamoya disease STA-MCA anastomosis clamp time ischemia anastomotic site micro-forceps |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1269400/full |
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