Histopathological Validation of Microvascular Anastomosis using Two-Throw Reef Knots - An Experimental Study.

Background: Knot configuration is an important but relatively neglected topic in microvascular anastomosis literature.

Objective: To study the differences between end-to-end microvascular anastomosis performed with two-throw reef knots as compared to traditional three-throw knots in a rat femoral artery model at the histological level.

Material And Methods: Sprague Dawley rats underwent end-to-end microvascular anastomosis of the right femoral artery (one-way-up method).

The Use of Retraction Sutures in End-To-Side Microvascular Anastomosis-A Novel Technical Innovation in Experimental Rat Femoral Model with Successful Use in STA-MCA Bypass in Moyamoya Disease.

Background: A narrow working space, small diameters, and the tendency to collapse with clamps make cerebral microvascular anastomosis challenging. A retraction suture (RS) is a novel technique to keep the recipient vessel lumen open during the bypass.

Objective: To provide a step-by-step overview of RS for end-to-side (ES) microvascular anastomosis on rat femoral vessels and successful use for superficial temporal artery to middle cerebral artery (STA-MCA) bypass in Moyamoya disease patients.

Toe-First Technique for End to Side Microvascular Anastomosis.

Background: The use of the classic 2-ends anchoring technique is common in end-to side (ES) microvascular anastomosis. The literature on the toe-first (TF) technique is limited. In the current study we present the successful outcomes with the TF technique in ES anastomoses in rat femoral vessels model.

Removal of Perirolandic Cavernoma with Direct Cortical Stimulation and Neuronavigation with DTI.

Background And Introduction: Intraoperative neuromonitoring for eloquent cortical lesions is irreplaceable in present-day neurosurgery.

Objective: We report a novel technique of combining awake craniotomy with direct cortical stimulation of the motor cortex using the NIM nerve monitoring system.

Technique: A 17-year-old boy presenting with focal motor seizures, diagnosed with left perirolandinc cavernoma, underwent awake craniotomy and complete excision under direct cortical stimulation with NIM monopolar stimulator electrode to locate the motor cortex.

End-to-Side Microvascular Anastomosis on Rat Femoral Vessels Using Only 2-Throw Knot Interrupted Sututres - Evaluation of Feasibility and Patency Rates on Rat Femoral Vessels Model.

Background: The use of a 3-throw knot for anastomosis by microvascular neurosurgeons is the usual standard. There is an inherent belief that the third throw adds extra security to the knot; however, the third throw can make the knot heavy and unbalanced and can exert undue extra pressure on the opposing walls of the small-caliber intracranial vessels. This study evaluated the feasibility and efficiency of 2-throw reef knot interrupted sutures for an end-to-side microvascular anastomosis.

Microvascular Anastomosis Using Only 2-Throw Reef-Knots: A Technical Note.

In macrosurgery creating a knot with at least three throws is an established practice. The potential disadvantages of this practice in microsurgery include the following: the direction of the cut ends interfere with the suture line, unbalanced nature of knot disturbs the apposition of delicate vessel ends and the excessive knot weight. A reef knot with only 2 throws may thus be a better alternative.

Predictors of outcome of subdural empyema in children.

Objective: The aim of this study was to report the etiology, clinical features, microbiology, surgical outcome, and predictors of outcome of spontaneous subdural empyema (SDE).

Methods: The authors conducted a retrospective study in a tertiary hospital. Children up to 18 years of age, with a diagnosis of SDE with infective etiology, were included in the present cohort.

Inverted (Buried) Reef Knot in Microsurgery - A Technical Note.

In side to side anastomosis and end to end (one way up) microvascular anastomosis, the back wall of the vessel is sutured first with inverted/buried knots. A common mistake made by surgeons during this step is the formation of a granny knot. In inverted suturing, cut ends of granny knot points inside the vessel lumen and interfere with the suture line.

Successful Development by Design of Experiments of a Gas Chromatography Method for Simultaneous Analysis of Residual Solvents of Classes 1 and 2.

In this study, design of experiments (DoE) was employed to develop a single injection method using a headspace gas chromatograph with flame ionization detector for resolution of residual solvents of United States Pharmacopeia (USP) listed classes 1 and 2, against current recommendation of independent injections. G43 column (6% cyanopropylphenyl and 94% dimethylpolysiloxane) and nitrogen were used as the stationary phase and carrier gas, respectively. Initial temperature, hold time, temperature ramp and carrier gas velocity were the critical method parameters.