Verfügbarkeit: Surgical techniques in Moyamoya vasculopathy

Surgical techniques in Moyamoya vasculopathy: tricks of the trade

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Bibliographische Detailangaben
Beteilige Person:	Vajkoczy, Peter 1968- (VerfasserIn)
Format:	Buch
Sprache:	Englisch
Veröffentlicht:	Stuttgart Thieme [2020]
Ausgabe:	1. Auflage
Schlagwörter:	Bypassoperation Hirnchirurgie Moyamoya-Krankheit Neurochirurgie
Links:	http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=031587993&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA
Umfang:	xxi, 184 Seiten Illustrationen 27 cm x 19.5 cm
ISBN:	9783131450616 3131450614

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Datensatz im Suchindex

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adam_text	CONTENTS FOREWORD ......................................................................................................................... XVI PREFACE ............................................................................................................................ XVIII CONTRIBUTORS ................................................................................................................... XIX PART 1 GENERAL CONCEPTS 1 PERIOPERATIVE MANAGEMENT AND CONSIDERATIONS ...................................................... 2 BETTINA FDHRE AND SUSANNE KONIG 1 PERIOPERATIVE MANAGEMENT AND CONSIDERATIONS ...................................................... 2 BETTINA FDHRE AND SUSANNE KONIG 3.3 PATHOPHYSIOLOGY ...................................... 14 1.1 PHYSIOLOGY ................................................ 2 1.3 POSTOPERATIVE CARE FOR MOYAMOYA DISEASE PATIENTS ...................................... 6 1.1.1 BASIC PHYSIOLOGY OF CEREBRAL BLOOD FLOW .. 2 1.1.2 WHAT IS DIFFERENT IN PATIENTS WITH 1.3.1 WHERE? ........................................................ 6 MOYAMOYA DISEASE? ................................... 2 1.3.2 PAIN CONTROL ................................................ 6 1.2 ANESTHESIA ................................................ 2 1.4 THREATS OF ANESTHESIA FOR MOYAMOYA DISEASE SURGERY ........................................ 7 1.2.1 CHOICE OF ANESTHESIA TECHNIQUE ............... 2 1.2.2 PREOPERATIVE EVALUATION AND 1.4.1 ISCHEMIC STROKE AND TRANSIENT ISCHEMIC PREMEDICATION ............................................ 3 ATTACKS ........................................................ 7 1.2.3 MONITORING .................................................. 4 1.4.2 CEREBRAL HYPERPERFUSION SYNDROME .......... 7 1.2.4 TARGETS OF ANESTHESIA ................................. 4 1.2.5 INDUCTION AND MAINTENANCE ....................... 5 REFERENCES .................................................. 7 1.2.6 EMERGENCE .................................................. 5 SUGGESTED READINGS ................................. 7 2 GENERAL PRINCIPLES OF DIRECT BYPASS SURGERY. .. 8 MARCUS CZABANKA AND PETER VAJKOCZY 2.1 HISTORY AND INITIAL DESCRIPTION ............. 8 2.3.3 STANDARDIZED STRATEGIES VERSUS TARGETED BYPASS PROCEDURES ...................................... 10 2.2 ANALYSIS OF HEMODYNAMIC COMPROMISE 2.3.4 PERI- AND INTRAOPERATIVE MANAGEMENT AND FOR DIRECT BYPASS SURGERY ....................... 8 NEUROPROTECTION ........................................ 11 2.3.5 INTRAOPERATIVE FLOW ASSESSMENT ............... 11 2.3 KEY PRINCIPLES OF DIRECT REVASCULARIZATION SURGERY ..................... 9 2.4 GENERAL COMPLICATIONS AND RISK STRATIFICATION ............................................ 11 2.3.1 GRAFT CHOICE ................................................ 9 2.3.2 RECIPIENT ARTERY ........................................ 10 REFERENCES .................................................. 12 3 GENERAL PRINCIPLES OF INDIRECT BYPASS SURGERY. 14 SATOSHI KURODA 3.1 INTRODUCTION .............................................. 14 3.4 CONCEPT OF INDIRECT BYPASS SURGERY. ... 15 3.2 HISTORY AND INITIAL DESCRIPTION ............. 14 REFERENCES .................................................. 16 V PART 2 INDIRECT REVASCULARIZATION 4 MULTIPLE BURR HOLES ....................................................................................................... 20 THOMAS BLAUWBLOMME, PHILIPPE MEYER, AND CHRISTIAN SAINTE-ROSE 4.1 HISTORY AND INITIAL DESCRIPTION ............ . 20 4.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS .......................................... 21 4.2 INDICATIONS .............................................. . 20 4.8 SPECIAL INSTRUCTIONS, POSITION, AND 4.3 KEY PRINCIPLES ........................................... . 20 ANESTHESIA ................................................ 21 4.4 SWOT ANALYSIS ......................................... . 20 4.8.1 ANESTHESIA .................................................. 21 4.8.2 POSITION ........................................................ 22 4.4.1 STRENGTHS .................................................. 20 4.4.2 WEAKNESS .................................................. . 21 4.9 SKIN INCISION AND KEY SURGICAL STEPS ... 22 4.4.3 OPPORTUNITIES ............................................. . 21 4.4.4 THREATS ...................................................... . 21 4.10 DIFFICULTIES ENCOUNTERED ......................... 23 4.5 CONTRAINDICATIONS ................................... . 21 4.11 BAILOUT, RESCUE, AND SALVAGE MANEUVERS ................................................ 23 4.6 SPECIAL CONSIDERATIONS ......................... . 21 4.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 23 4.6.1 IMAGING ...................................................... . 21 4.6.2 PATIENT ........................................................ . 21 REFERENCES .................................................. 24 5 ENCEPHALO-MYO-SYNANGIOSIS ... NILS HECHT AND PETER VAJKOCZY 25 5.1 HISTORY AND INITIAL DESCRIPTION ............ . 25 5.9.1 PATIENT POSITION AND SKIN INCISION .............. 27 5.9.2 PTERIONAL SKIN INCISION ............................... 27 5.2 INDICATIONS .............................................. . 25 5.9.3 SEPARATE SKIN AND MUSCLE FLAPS ............... 28 5.9.4 MOBILIZATION OF THE TEMPORALIS MUSCLE ... 28 5.3 KEY PRINCIPLES .......................................... . 25 5.9.5 ELEVATION OF THE MUSCLE FLAP ..................... 28 5.9.6 CRANIOTOMY AND DRILLING OF THE SPHENOID 5.4 SWOT ANALYSIS ......................................... . 26 5.9.7 WING ............................................................ OPENING OF THE DURA AND ENCEPHALO- 28 5.4.1 STRENGTHS .................................................. . 26 DURO-SYNANGIOSIS ........................................ 28 5.4.2 WEAKNESSES .............................................. . 26 5.9.8 SUTURING OF THE MUSCLE FASCIA TO THE EDGE 5.4.3 OPPORTUNITIES ............................................ . 26 OF THE DURAL OPENING ................................. 28 5.4.4 THREATS ...................................................... . 26 5.9.9 BONE FLAP REIMPLANTATION ......................... 29 5.5 CONTRAINDICATIONS ................................... . 26 5.10 DIFFICULTIES ENCOUNTERED ......................... 29 5.6 SPECIAL CONSIDERATIONS ......................... . 26 5.11 BAILOUT, RESCUE, AND SALVAGE MANEUVERS ................................................ 31 5.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS ......................................... . 26 5.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 31 5.8 SPECIAL INSTRUCTIONS, POSITION, AND ANESTHESIA .............................................. . 27 REFERENCES .................................................. 31 5.9 KEY SURGICAL STEPS ................................... . 27 VI 32 6 ENCEPHALO-DURO-ARTERIO-SYNANGIOSLS: PEDIATRIC EDWARD SMITH HAO JIANG, MICHAEI SCHIRALDI, AND NESTOR R. GONZALEZ 6.1 HISTORY AND INITIAL DESCRIPTION .......... .. 32 6.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS .......................................... 34 6.2 INDICATIONS ............................................ .. 32 6.8 SPECIAL INSTRUCTIONS, POSITION, AND 6.3 KEY PRINCIPLES ........................................ .. 32 ANESTHESIA ................................................ 34 6.4 SWOT ANALYSIS ...................................... .. 33 6.9 PATIENT POSITION WITH SKIN INCISION AND KEY SURGICAL STEPS ..................................... 34 6.4.1 STRENGTHS ................................................ .. 33 6.4.2 WEAKNESSES ............................................ .. 33 6.10 DIFFICULTIES ENCOUNTERED ......................... 38 6.4.3 OPPORTUNITIES .......................................... .. 33 6.4.4 THREATS .................................................... .. 33 6.11 BAILOUT, RESCUE, AND SALVAGE MANEUVERS ................................................ 38 6.5 CONTRAINDICATIONS ................................. .. 33 6.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 38 6.5.1 GENERAL CONTRAINDICATIONS TO REVASCULARIZATION SURGERY ..................... .. 33 SUGGESTED READINGS ................................. 39 6.5.2 SPECIFIC CONTRAINDICATIONS TO EDAS .... .. 33 6.6 SPECIAL CONSIDERATIONS ....................... .. 33 7 ENCEPHALO-DURO-ARTERIO-SYNANGIOSIS: IN ADULTS 40 7.1 HISTORY AND INITIAL DESCRIPTION ............. 40 7.8 PREOPERATIVE WORKUP ............................. 45 7.1.1 LITERATURE SUPPORT FOR THE USE OF EDAS IN 7.8.1 SPECIFIC CONSIDERATION WITH ADULTS ......................................................... 40 ANTICOAGULATION .......................................... 45 7.2 INDICATIONS ................................................ 40 7.9 PATIENT PREPARATION ................................. 45 7.3 KEY PRINCIPLES FOR THE EDAS SURGERY IN 7.9.1 PATIENT POSITION WITH SKIN INCISION ............ 45 ADULTS ......................................................... 43 7.10 SURGICAL STEPS ............................................ 46 7.4 SWOT ANALYSIS .......................................... 43 7.10.1 STA DISSECTION ............................................ 46 7.4.1 STRENGTHS .................................................... 43 7.10.2 STA CARE AND PRESERVATION ......................... 47 7.4.2 WEAKNESSES ................................................ 43 7.10.3 CRANIOTOMY .................................................. 47 7.4.3 OPPORTUNITIES .............................................. 43 7.10.4 MIDDLE MENINGEAL ARTERY PRESERVATION ... 47 7.4.4 THREATS ....................................................... 44 7.10.5 CEREBROSPINAL FLUID RELEASE ....................... 47 7.10.6 DURAL FLAPS PREPARATION AND SUPERFICIAL 7.5 SPECIFIC ADULT EDAS TEMPORAL ARTERY FIXATION ........................... 47 CONTRAINDICATIONS .................................... 44 7.10.7 CRANIOTOMY CLOSURE ................................... 47 7.5.1 ABSOLUTE ..................................................... 44 7.11 DIFFICULTIES ENCOUNTERED AND PEARLS OF 7.5.2 RELATIVE ....................................................... 44 MANAGEMENT ............................................ 50 7.5.3 NOT CONTRAINDICATIONS ................................. 44 7.12 PITFALLS ........................................................ 50 7.6 SPECIAL CONSIDERATIONS ........................... 44 7.13 BAILOUT, RESCUE, AND SALVAGE 7.6.1 CARE BEYOND THE SURGICAL FIELD ................. 44 MANEUVERS ................................................ 50 7.7 RISK ASSESSMENT AND COMPLICATIONS ... 45 7.14 POSTOPERATIVE CARE ................................... 50 VII GIUSEPPE ESPOSITO, ANNICK KRONENBURG, JORN FIERSTRA, KEES P.J. BRAUN, CATHARINA J.M. KLIJN, 7.14.1 PATIENT SURVEILLANCE ............................. ... 50 7.14.4 ADVANCED IMAGING ......................... ............ 50 7.14.2 EDAS FUNCTIONAL ASSESSMENT ................ ... 50 7.14.3 EDAS ANGIOGRAPHIC ASSESSMENT .......... ... 50 REFERENCES ..................................... ............ 50 8 BIFRONTAL ENCEPHALO-DURO-PERIOSTEAL-SYNANGIOSIS COMBINED WITH STA-MCA BYPASS .................... ............ 52 REFERENCES .................................................. 57 ALBERT VAN DERZWAN, AND LUCA REGLI 8.1 HISTORY AND INITIAL DESCRIPTION .............. 52 8.9 PATIENT POSITION WITH SKIN INCISION AND KEY SURGICAL STEPS ..................................... 54 8.2 INDICATIONS ................................................ 53 8.9.1 DIRECT (STA-MCA) AND INDIRECT (EDMS) 8.3 KEY PRINCIPLES ............................................ 53 BYPASS FOR UNILATERAL MCA TERRITORY REVASCULARIZATION ....................................... 54 8.4 SWOT ANALYSIS ........................................... 53 8.9.2 BIFRONTAL EDPS ............................................ 56 8.5 CONTRAINDICATIONS ..................................... 54 8.10 DIFFICULTIES ENCOUNTERED ......................... 57 8.6 SPECIAL CONSIDERATIONS ........................... 54 8.11 BAILOUT, RESCUE, AND SALVAGE MANOEUVRES .............................................. 57 8.7 COMPLICATIONS .......................................... 54 8.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 57 8.8 SPECIAL INSTRUCTIONS AND ANESTHESIA ... 54 PART 3 DIRECT REVASCULARIZATION 9 STA-MCA BYPASS FOR DIRECT REVASCULARIZATION ALESSANDRO NARDUCCI AND PETER VAJKOCZY I IN MOYAMOYA DISEASE ................. 60 9.1 HISTORY AND INITIAL DESCRIPTION .............. 60 9.8 SPECIAL INSTRUCTIONS, POSITION, AND ANESTHESIA ................................................ 62 9.2 INDICATIONS ................................................ 60 9.9 PATIENT POSITION WITH SKIN INCISION AND 9.3 KEY PRINCIPLES ............................................ 61 KEY SURGICAL STEPS ..................................... 62 9.4 SWOT ANALYSIS ........................................... 61 9.9.1 PREPARATION .................................................. 62 9.9.2 SURGICAL TECHNIQUE ..................................... 62 9.4.1 STRENGTHS .................................................... 61 9.4.2 WEAKNESSES ................................................ 61 9.10 DIFFICULTIES ENCOUNTERED ......................... 66 9.4.3 OPPORTUNITIES .............................................. 61 9.4.4 THREATS ........................................................ 61 9.11 BAILOUT, RESCUE, AND SALVAGE MANEUVERS ................................................ 66 9.5 CONTRAINDICATIONS ..................................... 61 9.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 67 9.6 SPECIAL CONSIDERATIONS ........................... 61 9.12.1 PREOPERATIVE EVALUATIONS ........................... 67 9.6.1 PREOPERATIVE IMAGING ................................. 61 9.12.2 TECHNICAL TIPS ............................................ 67 9.6.2 ANTICOAGULATION .......................................... 61 9.12.3 POSTOPERATIVE CARE ..................................... 67 9.6.3 OTHER CONSIDERATIONS ................................. 61 REFERENCES .................................................. 67 9.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS .......................................... 61 VIII 68 10 DOUBLE-BARREL BYPASS IN MOYAMOYA DISEASE JOHN 5. WANEBO AND ROBERT F. SPETZLER 10.1 HISTORY AND INITIAL DESCRIPTION .............. 68 10.9 SKIN INCISION AND KEY SURGICAL STEPS ... 70 10.2 INDICATIONS ................................................ 68 10.9.1 SKIN INCISION AND DISSECTION OFSTA .......... 70 10.9.2 TEMPORAL MUSCLE DISSECTION AND 10.3 KEY PRINCIPLES OF THE DOUBLE-BARREL CRANIOTOMY .................................................. 71 BYPASS ....................................................... 69 10.9.3 DURAL OPENING ............................................ 71 10.9.4 ANASTOMOTIC SITE SELECTION ......................... 72 10.4 SWOT ANALYSIS .......................................... 69 10.9.5 DONOR STA PREPARATION ............................... 72 10.9.6 RECIPIENT MCA BRANCH PREPARATION .......... 73 10.4.1 STRENGTHS .................................................... 69 10.9.7 MCA ARTERIOTOMY ...................................... 73 10.4.2 WEAKNESSES ................................................ 69 10.9.8 ANASTOMOSIS ................................................ 73 10.4.3 OPPORTUNITY ................................................ 69 10.9.9 GRADED RELEASE OF THE TEMPORARY CLIPS 10.4.4 THREATS ....................................................... 69 AND HEMOSTASIS .......................................... 74 10.9.10 SECOND ANASTOMOSES ................................. 74 10.5 CONTRAINDICATIONS .................................... 69 10.9.11 CLOSURE PHASE .............................................. 75 10.9.12 POSTOPERATIVE CARE ..................................... 75 10.6 SPECIAL CONSIDERATIONS ........................... 69 10.10 DIFFICULTIES ENCOUNTERED ......................... 75 10.7 RISK ASSESSMENT AND COMPLICATIONS ... 69 10.11 BAILOUT, RESCUE, AND SALVAGE 10.8 SPECIAL INSTRUCTIONS, POSITION, AND MANEUVERS ................................................ 75 ANESTHESIA ................................................ 69 10.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 75 10.8.1 PREOPERATIVE WORKUP ................................. 69 10.8.2 PATIENT POSITION .......................................... 70 REFERENCES .................................................. 76 10.8.3 ANESTHESIA .................................................. 70 11 OCCIPITAL ARTERY-MIDDLE CEREBRAL ARTERY BYPASS IN MOYAMOYA DISEASE 77 KEN KAZUMATA 12 STA-ACA/MCA DOUBLE BYPASSES WITH LONG GRAFTS 80 AKITSUGU KAWASHIMA 12.1 HISTORY AND INITIAL DESCRIPTION 80 12.2 INDICATIONS 80 11.1 HISTORY AND INITIAL DESCRIPTION ........ ... 77 11.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS .......................................... 78 11.2 INDICATIONS .......................................... ... 77 11.8 SPECIAL INSTRUCTIONS, POSITION, AND 11.3 KEY PRINCIPLES ...................................... ... 77 ANESTHESIA ................................................ 78 11.4 SWOT ANALYSIS .................................... ... 77 11.9 PATIENT POSITION WITH SKIN INCISION AND KEY SURGICAL STEPS .................................... 78 11.4.1 STRENGTHS .............................................. ... 77 11.4.2 WEAKNESSES .......................................... ... 77 11.10 DIFFICULTIES ENCOUNTERED ......................... 78 11.4.3 OPPORTUNITIES ........................................ ... 77 11.4.4 THREATS .................................................. ... 77 11.11 BAILOUT, RESCUE, AND SALVAGE MANEUVERS ................................................ 79 11.5 CONTRAINDICATIONS ............................... ... 77 11.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 79 11.6 SPECIAL CONSIDERATIONS ..................... ... 78 REFERENCES .................................................. 79 IX SUGGESTED READINGS ................................. 84 12.3 KEY PRINCIPLE OF STA-ACA/MCA DOUBLE BYPASSES WITH LONG CRAFTS ..................... 80 12.8 SPECIAL INSTRUCTIONS, POSITION, AND ANESTHESIA ................................................ 81 12.4 SWOT ANALYSIS ........................................... 80 12.9 PATIENT POSITION WITH SKIN INCISION AND KEY SURGICAL STEPS ..................................... 82 12.4.1 STRENGTH ...................................................... 80 12.4.2 WEAKNESSES ................................................ 80 12.10 DIFFICULTIES ENCOUNTERED ......................... 83 12.4.3 OPPORTUNITY ................................................ 81 12.4.4 THREATS ........................................................ 81 12.11 BAILOUT, RESCUE, AND SALVAGE MANEUVERS ................................................ 83 12.5 CONTRAINDICATIONS ..................................... 81 12.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 84 12.6 SPECIAL CONSIDERATIONS ........................... 81 12.12.1 GRAFT MANAGEMENT ..................................... 84 12.7 PITFALLS, RISK ASSESSMENT, AND 12.12.2 ANASTOMOSIS ................................................ 84 COMPLICATIONS ........................................... 81 12.12.3 TRAINING ........................................................ 84 13 DOUBLE ANASTOMOSIS USING ONLY ONE BRANCH OF THE SUPERFICIAL TEMPORAL ARTERY: SINGLE-VESSEL DOUBLE ANASTOMOSIS ............................................................... 85 ZIAD A. HAGE, GREGORY D. ARNONE , AND FADY T. CHARBEL SUGGESTED READINGS ................................. 92 13.1 HISTORY AND INITIAL DESCRIPTION ........ ... 85 13.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS .......................................... 87 13.2 INDICATIONS ........................................... ... 85 13.8 SPECIAL INSTRUCTIONS, POSITION, AND 13.3 KEY PRINCIPLES ....................................... ... 85 ANESTHESIA ................................................ 87 13.4 SWOT ANALYSIS ..................................... ... 86 13.9 SKIN INCISION AND KEY SURGICAL STEPS ... 88 13.4.1 STRENGTHS .............................................. ... 86 13.10 DIFFICULTIES ENCOUNTERED ......................... 91 13.4.2 WEAKNESSES .......................................... ... 86 13.4.3 OPPORTUNITIES ......................................... ... 86 13.11 BAILOUT, RESCUE, AND SALVAGE 13.4.4 THREATS .................................................. ... 86 MANEUVERS ................................................ 91 13.5 CONTRAINDICATIONS ............................... ... 86 13.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 91 13.6 SPECIAL CONSIDERATIONS ..................... ... 87 REFERENCES .................................................. 92 PART 4 COMBINED REVASCULARIZATION 14 COMBINED STA-MCA BYPASS AND ENCEPHALO-MYO-SYNANGIOSIS .............................. 94 MARCUS CZABANKA AND PETER VAJKOCZY 14.1 HISTORY AND INITIAL DESCRIPTION ........ ... 94 14.4.2 WEAKNESSES ..................................... .......... 95 14.4.3 OPPORTUNITIES ................................... .......... 95 14.2 INDICATIONS ........................................... ... 94 14.4.4 THREATS ............................................ .......... 95 14.3 KEY PRINCIPLES ....................................... ... 94 14.5 CONTRAINDICATIONS ......................... .......... 95 14.4 SWOT ANALYSIS ..................................... ... 94 14.6 SPECIAL CONSIDERATIONS ................ .......... 95 14.4.1 STRENGTHS .............................................. ... 94 X EREZ NOSSEK, ANNICK KRONENBURG, AND DAVID J. LANGER 14.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS .......................................... 96 14.11 BAILOUT, RESCUE, AND SALVAGE MANEUVERS ................................................ 99 14.8 SPECIAL INSTRUCTIONS, POSITION, AND ANESTHESIA ................................................ 96 14.12 TIPS, PEARLS, AND LESSONS LEARNED .......... 99 REFERENCES .................................................. 99 14.9 PATIENT POSITION AND KEY SURGICAL STEPS 97 14.10 DIFFICULTIES ENCOUNTERED ......................... 98 15 STA-MCA BYPASS AND EMS/EDMS KEN KAZUMATA AND KIYOHIRO HOUKIN 100 15.1 HISTORY AND INITIAL DESCRIPTION .............. 100 15.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS .......................................... 102 15.2 INDICATIONS ................................................ 100 15.8 SPECIAL INSTRUCTIONS, POSITION, AND 15.3 KEY PRINCIPLES ............................................ 100 ANESTHESIA ................................................ 102 15.4 SWOT ANALYSIS .......................................... 100 15.9 PATIENT POSITION WITH SKIN INCISION AND KEY SURGICAL STEPS ..................................... 103 15.4.1 STRENGTHS .................................................... 100 15.4.2 WEAKNESSES ................................................ 100 15.10 DIFFICULTIES ENCOUNTERED ......................... 103 15.4.3 OPPORTUNITIES .............................................. 100 15.4.4 THREATS ....................................................... 100 15.11 BAILOUT, RESCUE, AND SALVAGE MANEUVERS ................................................ 103 15.5 CONTRAINDICATIONS .................................... 100 15.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 103 15.6 SPECIAL CONSIDERATIONS ........................... 100 REFERENCES .................................................. 105 16 COMBINED DIRECT (STA-MCA) AND INDIRECT (EDAS) EC-IC BYPASS .......................... 106 16.1 HISTORY AND INITIAL DESCRIPTION ........ ... 106 16.8 SPECIAL INSTRUCTIONS, POSITION, AND ANESTHESIA ................................................ 108 16.2 INDICATIONS .......................................... ... 106 16.9 PATIENT POSITION WITH SKIN INCISION AND 16.3 KEY PRINCIPLES ...................................... ... 107 KEY SURGICAL STEPS .................................... 108 16.4 SWOT ANALYSIS .................................... ... 107 16.9.1 DESCRIPTION OF THE TECHNIQUE ..................... 108 16.5 CONTRAINDICATIONS ............................... ... 107 16.10 DIFFICULTIES ENCOUNTERED ......................... 111 16.6 SPECIAL CONSIDERATIONS ..................... ... 107 16.11 BAILOUT, RESCUE, AND SALVAGE MANEUVERS ................................................ 115 16.6.1 PREOPERATIVE CONSIDERATIONS ............... ... 107 16.6.2 POSTOPERATIVE CONSIDERATIONS ............. ... 107 16.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 115 16.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS .................................... ... 108 REFERENCES .................................................. 115 XI 17 STA-MCA ANASTOMOSIS AND EDMARS ........................................................................ SATOSHI KURODA 116 17.1 HISTORY AND INITIAL DESCRIPTION .............. 116 17.8 PATIENT POSITION WITH SKIN INCISION AND KEY SURGICAL STEPS ..................................... 119 17.1.1 STA-MCA ANASTOMOSIS AND EDMAPS AS AN * ULTIMATE * BYPASS ....................................... 116 17.8.1 SKIN INCISION AND DONOR TISSUE PREPARATION .................................................. 119 17.2 INDICATIONS AND CONTRAINDICATIONS ........ 116 17.8.2 CRANIOTOMY AND DURAL OPENING ................. 119 17.8.3 DIRECT STA-MCA ANASTOMOSIS ................... 120 17.2.1 ASYMPTOMATIC MOYAMOYA DISEASE ............ 118 17.8.4 INDIRECT BYPASS AND CRANIOPLASTY .............. 122 17.2.2 ISCHEMIC-TPE MOYAMOYA DISEASE .............. 118 17.2.3 HEMORRHAGIC-TYPE MOYAMOYA DISEASE ... 118 17.9 DIFFICULTIES ENCOUNTERED ......................... 122 17.3 KEY PRINCIPLES ............................................ 119 17.9.1 PRESERVATION OF SCALP BLOOD FLOW .............. 122 17.9.2 PRESERVATION OF THE MMA DURING 17.4 SWOT ANALYSIS ........................................... 119 CRANIOTOMY .................................................. 123 17.9.3 ICG VIDEOANGIOGRAPHY BEFORE CRANIOTOMY 124 17.5 SPECIAL CONSIDERATIONS ........................... 119 17.9.4 STA-MCA ANASTOMOSIS ............................. 125 17.6 PITFALLS, RISK ASSESSMENT, AND 17.10 BAILOUT, RESCUE, AND SALVAGE COMPLICATIONS .......................................... 119 MANEUVERS ................................................ 125 17.7 SPECIAL INSTRUCTIONS AND ANESTHESIA ... 119 REFERENCES .................................................. 125 18 STA-MCA BYPASS AND ENCEPHALO-DURO-ARTERIO-SYNANGIOSIS ................................... 126 SEPIDEH AMIN-HANJANI 18.1 HISTORY AND INITIAL DESCRIPTION .............. 126 18.9.3 CRANIOTOMY .................................................. 129 18.9.4 RECIPIENT VESSEL PREPARATION ..................... 129 18.2 INDICATIONS ................................................ 126 18.9.5 DONOR VESSEL PREPARATION ........................... 130 18.9.6 STA-MCA BYPASS........................................ 130 18.3 KEY PRINCIPLES ............................................ 127 18.9.7 ENCEPHALO-ARTERIO-SYNANGIOSIS ................. 131 18.9.8 ENCEPHALO-DURO-SYNANGIOSIS ..................... 131 18.4 SWOT ANALYSIS ........................................... 127 18.9.9 CLOSURE ........................................................ 131 18.4.1 STRENGTHS .................................................... 127 18.10 DIFFICULTIES ENCOUNTERED ......................... 133 18.4.2 WEAKNESSES ................................................ 127 18.4.3 OPPORTUNITY ................................................ 127 18.10.1 DONOR VESSEL .............................................. 133 18.4.4 THREAT .......................................................... 127 18.10.2 CRANIOTOMY/DUROTOMY ............................... 133 18.10.3 RECIPIENT VESSEL .......................................... 133 18.5 CONTRAINDICATIONS ..................................... 127 18.10.4 ANASTOMOSIS ................................................ 133 18.10.5 CLOSURE ........................................................ 133 18.6 SPECIAL CONSIDERATIONS ........................... 127 18.11 BAILOUT, RESCUE, AND SALVAGE 18.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS .......................................... 128 MANEUVERS ................................................ 133 18.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 134 18.8 SPECIAL INSTRUCTIONS, POSITION, AND ANESTHESIA ................................................ 128 18.12.1 PREOPERATIVE MANAGEMENT ......................... 134 PATIENT POSITION WITH SKIN INCISION AND 18.12.2 INTRAOPERATIVE ANESTHETIC MANAGEMENT .. 134 18.9 128 18.12.3 INTRAOPERATIVE TECHNIQUE ........................... 134 KEY SURGICAL STEPS ..................................... REFERENCES .................................................. 135 18.9.1 POSITION ........................................................ 128 18.9.2 SKIN INCISION AND STA HARVEST ................... 128 XII 19 INDIVIDUALIZED EXTRACRANIAL-INTRACRANIAL REVASCULARIZATION IN THE TREATMENT OF LATE-STAGE MOYAMOYA DISEASE .................................................................................... 136 BIN XU PART 5 RESCUE STRATEGIES FOR REPEAT SURGERY 19.1 HISTORY AND INITIAL DESCRIPTION ........... .. 136 19.9 PATIENT POSITION WITH SKIN INCISION AND KEY SURGICAL STEPS ..................................... 140 19.2 INDICATIONS .............................................. . 136 19.9.1 SKIN INCISION ................................................ 140 19.3 KEY PRINCIPLES .......................................... . 136 19.9.2 TEMPORAL MUSCLE ........................................ 140 19.9.3 BONE FLAP .................................................... 140 19.4 SWOT ANALYSIS ........................................ . 136 19.9.4 DURA MATER .................................................. 140 19.9.5 TARGET REVASCULARIZATION ........................... 144 19.4.1 STRENGTH .................................................... . 136 19.9.6 THE SIMPLEST ANASTOMOSIS TECHNIQUES. ... 146 19.4.2 WEAKNESSES .............................................. . 136 19.4.3 OPPORTUNITIES ............................................ . 136 19.10 DIFFICULTIES ENCOUNTERED ......................... 148 19.4.4 THREATS ..................................................... . 136 19.11 BAILOUT, RESCUE, AND SALVAGE 19.5 CONTRAINDICATIONS .................................. . 137 MANEUVERS ................................................ 148 19.6 SPECIAL CONSIDERATIONS ......................... . 137 19.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 148 19.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS ........................................ . 138 SUGGESTED READINGS ................................. 149 19.8 SPECIAL INSTRUCTIONS, POSITION, AND ANESTHESIA .............................................. . 139 20 OMENTAL-CRANIAL TRANSPOSITION ................................................................................... 152 MARIO TEO, JEREMIAH N. JOHNSON, AND GARY K. STEINBERG 20.1 BACKGROUND .......................................... .. 152 20.8.1 SPECIFIC CONSIDERATION WITH ANTICOAGULATION .......................................... 153 20.1.1 HISTORY .................................................... .. 152 20.9 PATIENT PREPARATION ................................. 153 20.2 INDICATIONS ............................................ .. 152 20.9.1 PATIENT POSITION WITH SKIN INCISION ............ 153 20.3 KEY PRINCIPLES ........................................ .. 152 20.10 SURGICAL STEPS ............................................ 154 20.4 SWOT ANALYSIS ...................................... .. 152 20.10.1 KEY PROCEDURAL STEP 1: OMENTAL HARVEST. . 154 20.4.1 STRENGTH .................................................. .. 152 20.10.2 KEY PROCEDURAL STEP 2: DELIVERY AND 20.4.2 WEAKNESS ................................................ .. 152 TUNNELING .................................................... 154 20.4.3 OPPORTUNITY ............................................ .. 152 20.10.3 KEY PROCEDURAL STEP 3: CRANIOTOMY .......... 154 20.4.4 THREAT ..................................................... .. 152 20.11 TIPS, PEARLS, AND LESSONS LEARNED ........ 154 20.5 CONTRAINDICATIONS ................................ .. 153 20.12 PITFALLS ........................................................ 154 20.6 SPECIAL CONSIDERATIONS ....................... .. 153 20.13 BAILOUT, RESCUE, AND SALVAGE 20.7 RISK ASSESSMENT: OUR EXPERIENCE ... .. 153 MANEUVERS ................................................ 156 20.8 PREOPERATIVE WORKUP ......................... .. 153 20.14 POSTOPERATIVE CARE ................................... 156 20.14.1 PATIENT SURVEILLANCE ................................... 156 XIII 20.14.2 BYPASS FUNCTION ASSESSMENT ............ ........ 158 20.15.2 CASE 2 .......................................... .............. 158 20.15 CASE ILLUSTRATIONS ............................. ........ 158 20.16 CONCLUSION ................................. .............. 158 20.15.1 CASE 1 ................................................ ........ 158 SUGGESTED READINGS ................. .............. 160 21 ECA-MCA BYPASS WITH RADIAL ARTERY GRAFT ................................................................ 161 SATOSHI HORI AND PETER VAJKOCZY 21.1 PITFALLS, RISK ASSESSMENT, AND 21.7 161 HISTORY AND INITIAL DESCRIPTION COMPLICATIONS .......................................... 162 21.2 INDICATIONS ................................................ 161 21.8 SPECIAL INSTRUCTIONS, POSITION, AND 21.3 KEY PRINCIPLES ............................................ 161 ANESTHESIA ................................................ 162 21.4 SWOT ANALYSIS ........................................... 162 21.9 PATIENT POSITION WITH SKIN INCISION AND KEY SURGICAL STEPS ..................................... 162 21.4.1 STRENGTH ...................................................... 162 21.4.2 WEAKNESSES ................................................ 162 21.10 DIFFICULTIES ENCOUNTERED ......................... 165 21.4.3 OPPORTUNITY ................................................ 162 21.4.4 THREAT .......................................................... 162 21.11 BAILOUT, RESCUE, AND SALVAGE MANEUVERS ................................................ 165 21.5 CONTRAINDICATIONS ..................................... 162 21.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 165 21.6 SPECIAL CONSIDERATIONS ........................... 162 REFERENCES .................................................. 167 22 OA-MCA OR OA-RCA BYPASS ...... 168 MARIO TEO , JEREMIAH N. JOHNSON, AND GARY K. STEINBERG 22.1 BACKGROUND .............................................. 168 22.8.1 SPECIFIC CONSIDERATION WITH ANTICOAGULATION .......................................... 169 22.1.1 HISTORY ........................................................ 168 22.9 PATIENT PREPARATION ................................. 169 22.2 INDICATION .................................................. 168 22.9.1 PATIENT POSITION WITH SKIN INCISION ............ 169 22.3 KEY PRINCIPLES ............................................ 168 22.10 SURGICAL STEPS ............................................ 169 22.4 SWOT ANALYSIS ........................................... 168 22.10.1 KEY PROCEDURAL STEP 1: OA HARVEST ............ 169 22.4.1 STRENGTH ...................................................... 168 22.10.2 KEY PROCEDURAL STEP 2: CRANIOTOMY AND 22.4.2 WEAKNESS .................................................... 168 DURAL OPENING ............................................ 171 22.4.3 OPPORTUNITY ................................................ 168 22.10.3 KEY PROCEDURAL STEP 3: PREPARE RECIPIENT 22.4.4 THREAT .......................................................... 168 22.10.4 VESSEL .......................................................... KEY PROCEDURAL STEP 4: PREPARE DONOR 171 22.5 CONTRAINDICATIONS ..................................... 168 22.10.5 VESSEL .......................................................... KEY PROCEDURAL STEP 5: 171 22.5.1 RELATIVE CONTRAINDICATIONS ......................... 169 22.10.6 MICROANASTOMOSIS ....................................... KEY PROCEDURAL STEP 6: ENSURE BYPASS 171 22.6 SPECIAL CONSIDERATIONS ........................... 169 GRAFT PATENCY .............................................. 171 22.10.7 KEY PROCEDURAL STEP 7: CLOSURE ................. 174 22.7 RISK ASSESSMENT * STANFORD EXPERIENCE 169 22.11 174 TIPS, PEARLS, AND LESSONS LEARNED ........ 22.8 PREOPERATIVE WORKUP ............................. 169 22.12 PITFALLS ........................................................ 174 XIV 22.13 BAILOUT, RESCUE, AND SALVAGE MANEUVERS .......................................... ... 174 22.15.1 22.15.2 CASE 1: OA-PCA BYPASS ............................. CASE 2: OA-MCA BYPASS............................. 174 177 22.14 POSTOPERATIVE CARE ............................. ... 174 22.16 CONCLUSION ................................................ 177 22.14.1 PATIENT SURVEILLANCE ............................. ... 174 SUGGESTED READINGS ................................. 177 22.14.2 BYPASS FUNCTION ASSESSMENT ............... ... 174 22.15 CASE ILLUSTRATIONS ................................. ... 174 23 PAA-MCA BYPASS .................... MENNO R. GERMANS AND LUCA REGLI 178 23.1 HISTORY AND INITIAL DESCRIPTION ........ ... 178 23.7 PITFALLS, RISK ASSESSMENT, AND COMPLICATIONS .......................................... 180 23.2 INDICATIONS .......................................... ... 179 23.8 SPECIAL INSTRUCTIONS, POSITION, AND 23.3 KEY PRINCIPLES ...................................... ... 179 ANESTHESIA ................................................ 180 23.4 SWOT ANALYSIS .................................... ... 179 23.9 PATIENT POSITION WITH SKIN INCISION AND KEY SURGICAL STEPS .................................... 180 23.4.1 STRENGTHS .............................................. ... 179 23.4.2 WEAKNESS .............................................. ... 179 23.10 DIFFICULTIES ENCOUNTERED ......................... 181 23.4.3 OPPORTUNITY .......................................... ... 179 BAILOUT, RESCUE, AND SALVAGE 23.4.4 THREAT .................................................... ... 179 23.11 181 MANEUVERS ................................................ 23.5 CONTRAINDICATIONS ............................... ... 179 23.12 TIPS, PEARLS, AND LESSONS LEARNED ........ 181 23.6 SPECIAL CONSIDERATIONS ..................... ... 180 REFERENCES .................................................. 181 INDEX ........................................ 182 XV
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author	Vajkoczy, Peter 1968-
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physical	xxi, 184 Seiten Illustrationen 27 cm x 19.5 cm
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spellingShingle	Vajkoczy, Peter 1968- Surgical techniques in Moyamoya vasculopathy tricks of the trade Bypassoperation (DE-588)4147089-8 gnd Hirnchirurgie (DE-588)4025006-4 gnd Moyamoya-Krankheit (DE-588)1201330661 gnd
subject_GND	(DE-588)4147089-8 (DE-588)4025006-4 (DE-588)1201330661
title	Surgical techniques in Moyamoya vasculopathy tricks of the trade
title_auth	Surgical techniques in Moyamoya vasculopathy tricks of the trade
title_exact_search	Surgical techniques in Moyamoya vasculopathy tricks of the trade
title_full	Surgical techniques in Moyamoya vasculopathy tricks of the trade Peter Vajkoczy
title_fullStr	Surgical techniques in Moyamoya vasculopathy tricks of the trade Peter Vajkoczy
title_full_unstemmed	Surgical techniques in Moyamoya vasculopathy tricks of the trade Peter Vajkoczy
title_short	Surgical techniques in Moyamoya vasculopathy
title_sort	surgical techniques in moyamoya vasculopathy tricks of the trade
title_sub	tricks of the trade
topic	Bypassoperation (DE-588)4147089-8 gnd Hirnchirurgie (DE-588)4025006-4 gnd Moyamoya-Krankheit (DE-588)1201330661 gnd
topic_facet	Bypassoperation Hirnchirurgie Moyamoya-Krankheit
url	http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=031587993&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA
work_keys_str_mv	AT vajkoczypeter surgicaltechniquesinmoyamoyavasculopathytricksofthetrade AT georgthiemeverlagkg surgicaltechniquesinmoyamoyavasculopathytricksofthetrade

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