Endoscopic radial artery harvesting for U-clip high-flow EC-IC bypass: technical report

Acta Neurochir (Wien). 2009 May;151(5):529-35; discussion 535. doi: 10.1007/s00701-009-0274-9. Epub 2009 Mar 25.


Introduction: Bypass and aneurysm trapping constitute a well-known surgical solution for aneurysms that are not suitable for clipping or coiling. New techniques are available that make EC-IC bypass procedures easier, safer and, possibly, less invasive. The nitinol self-closing U-Clip device (Medtronic, Inc., Minneapolis) has been designed to facilitate the interrupted suture technique by eliminating the need for suture management, knot tying, and surgical assistance.

Materials and methods: We present two consecutive U-clip bypass procedures in which the radial artery graft was harvested endoscopically.

Results: This novel bypass technique employs endoscopy to minimise arm injury due to radial artery harvesting and self-closing U-clips to simplify the intracranial micro-anastomosis and reduce the temporary occlusion time. Angiography confirmed bypass patency in all patients.

Discussion: Combined with the innovative use of U-clips, these two examples illustrate how new technologies can simplify EC-IC bypass surgery while yielding a better cosmetic and functional outcome.

Publication types

  • Case Reports
  • Technical Report

MeSH terms

  • Aged
  • Cerebral Angiography
  • Cerebral Revascularization / instrumentation
  • Cerebral Revascularization / methods*
  • Endoscopy*
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Radial Artery / surgery*
  • Radial Artery / transplantation*
  • Surgical Instruments
  • Treatment Outcome