Department of Neurological Surgery, University of California San Diego, San Diego, California.
Neurorestoration Cen-ter, Department of Neurological Surgery, The Keck School of Medicine, University of Southern California, Los Angeles, California.
Oper Neurosurg (Hagerstown). 2018 Oct 1;15(4):412-417. doi: 10.1093/ons/opx263.
The ideal suturing technique for microvascular anastomosis for neurosurgical bypass procedures remains a point of debate. Simple interrupted sutures are thought to possess higher long-term patency but require more time to place as compared to running sutures.
To optimize the efficiency of microvascular anastomosis and limit brain ischemia time.
The running-to-interrupted microsuture technique, a modification of the previously published spiral anastomosis, is described wherein loosely thrown running sutures are placed between 2 opposed anchor stitches. The loops are then serially cut and tied, resulting in efficiently placed interrupted stitches. This process is repeated on the opposite side to complete the anastomosis.
The running-to-interrupted microsuture technique is quickly learned, limits unnecessary microsurgical movements, and is employed by the senior author for a multitude of cerebral arterial bypass procedures.
This technical improvement can be adapted by any neurovascular surgeon to optimize microsurgical efficiency and limit anastomosis-related brain ischemia times.
神经外科旁路手术中微血管吻合的理想缝合技术仍存在争议。与连续缝合相比，单纯间断缝合被认为具有更高的长期通畅率，但需要更多的时间来进行缝合。
优化微血管吻合的效率并限制脑缺血时间。
描述了一种改良的螺旋吻合术，即连续到间断微缝线技术，其中在 2 个相对的锚定缝线之间放置松散抛出的连续缝线。然后将线环逐个剪断并打结，从而有效地进行间断缝合。在另一侧重复此过程以完成吻合。
连续到间断微缝线技术易于学习，限制了不必要的显微手术动作，并且被资深作者用于多种脑动脉旁路手术中。
任何神经血管外科医生都可以采用这种技术改进来优化显微手术效率并限制吻合相关的脑缺血时间。
