TY - JOUR
T1 - Sutureless repair of major intracranial vessels with the Sundt clip-graft
T2 - Technical note
AU - Lanzino, G.
AU - DiPierro, C. G.
AU - Laws, E. R.
PY - 1998
Y1 - 1998
N2 - Major intracranial vessels can be damaged during tumor resection. With the availability of refined microvascular techniques, direct repair or by-pass of the damaged segment is possible. These methods, however, often require temporary occlusion of the offending vessel, can result in a less than optimal angiographic result, and are difficult to perform in a deep field. Additionally, in some patients direct repair or by-pass is not feasible because of the friability of the vessel or as a result of the large size of the tear. In these cases the Sundt clip-graft represents a valid adjunct to the armamentarium of the surgeon. Over the years, it has been used by the senior author in five patients where vascular injury occurred during the removal of brain tumors (3 meningiomas, one pituitary adenoma, and one low-grade glioma). In this report we illustrate our most recent experience with this ingenious tool. A 22-year-old man underwent resection of a recurrent left temporal lobe low-grade glioma. During resection of the tumor, a tear occurred in a branch of the middle cerebral artery. The tear was repaired using a Sundt clip-graft. A post-operative angiogram, performed five days later, showed patency of the vessel with no evidence of wall irregularities. Described 30 years ago to be used primarily in aneurysm surgery, the Sundt clip-graft provides an excellent, too often forgotten, sutureless method of repairing intracranial vessels damaged during tumor removal.
AB - Major intracranial vessels can be damaged during tumor resection. With the availability of refined microvascular techniques, direct repair or by-pass of the damaged segment is possible. These methods, however, often require temporary occlusion of the offending vessel, can result in a less than optimal angiographic result, and are difficult to perform in a deep field. Additionally, in some patients direct repair or by-pass is not feasible because of the friability of the vessel or as a result of the large size of the tear. In these cases the Sundt clip-graft represents a valid adjunct to the armamentarium of the surgeon. Over the years, it has been used by the senior author in five patients where vascular injury occurred during the removal of brain tumors (3 meningiomas, one pituitary adenoma, and one low-grade glioma). In this report we illustrate our most recent experience with this ingenious tool. A 22-year-old man underwent resection of a recurrent left temporal lobe low-grade glioma. During resection of the tumor, a tear occurred in a branch of the middle cerebral artery. The tear was repaired using a Sundt clip-graft. A post-operative angiogram, performed five days later, showed patency of the vessel with no evidence of wall irregularities. Described 30 years ago to be used primarily in aneurysm surgery, the Sundt clip-graft provides an excellent, too often forgotten, sutureless method of repairing intracranial vessels damaged during tumor removal.
KW - Intraoperative complications
KW - Middle cerebral artery
KW - Sundt clip-graft
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U2 - 10.1007/s007010050130
DO - 10.1007/s007010050130
M3 - Article
C2 - 9728251
AN - SCOPUS:0031836606
SN - 0001-6268
VL - 140
SP - 491
EP - 493
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 5
ER -