Arteriotomy
CHAPTER 8 Arteriotomy Arteriotomy Basics Bypass construction begins by creating the largest possible inlets and outlets in arteries to minimize anastomotic resistance and maximize flow. Arteriotomies initiate new connections between…
Donors and Recipients
CHAPTER 5 Donors and Recipients Pairing Planning a bypass entails simply pairing the recipient artery in need of revascularization with a donor artery that may be intracranial, extracranial, cervical, or…
Tightening and Knotting
CHAPTER 11 Tightening and Knotting Tying the Knot Like the bolts that fasten steel beams framing a skyscraper, knots bind and hold tissues, begin and end each suture line, and…
Basilar Artery Bypass Strategy
CHAPTER 23 Basilar Artery Bypass Strategy Basilar Artery Bypass Strategy Bypasses to the basilar artery are the most difficult to perform. The basilar artery is entombed at the geographic center…
Bypass Patency
CHAPTER 12 Bypass Patency One Thousand Moves Bypass surgery consists of a thousand tiny moves, and it takes just one bad move to ruin the bypass. Errors are often unrecognized…
Aneurysm Occlusion
CHAPTER 13 Aneurysm Occlusion Aneurysm Attack A bypass performed for an aneurysm empowers and emboldens the neurosurgeon. Unlike a bypass for ischemia, the completion of which marks the end of…
Cross Clamp
CHAPTER 7 Cross Clamp Time Pressure The interruption of arterial flow with temporary clips and the dangers of cerebral ischemia suffuse bypass surgery with tension and stress. We may ask…
MCA Bypass Strategy
CHAPTER 21 MCA Bypass Strategy MCA Bypass Strategy Of the three main cerebral arteries, the MCA supplies the largest and most eloquent territory in the cerebral hemispheres. Communicating arteries on…
PICA Bypass Strategy
CHAPTER 24 PICA Bypass Strategy PICA Bypass Strategy PICA aneurysms account for 4% of my overall aneurysm experience. Although relatively few in number, they have an unusually high incidence of…
In the Zone
CHAPTER 6 In the Zone The Zone Being “in the zone” means getting to a state of consciousness where you are consumed by what you are doing and completely unaware…
