Mattress anastomosis in micro vascular reconstruction: technical note.

Background: Superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis is a common procedure for neurosurgeons. The surgery necessarily requires accurate and speedy manipulation of microscope, for which a specific training is needed. Unexpected bypass occlusion sometimes happen during surgery.

Objective: Generally, conventional interrupted or continuous suture has been used for vascular anastomosis, despite various ideas have been attempted in the other surgery fields. We propose a horizontal mattress suture technique for intracranial microvascular bypass surgery. This is the first report ever published on intracranial vascular anastomosis.

Methods: We had four patients of STA-MCA bypass surgery with "mattress anastomosis" from March to May of 2012.

Results: During the procedure, there was no bypass occlusion and good patency was confirmed in all cases.

Conclusion: Intimae of the recipient and the donor blood vessel contact each other precisely with this technique. Although a long-term assessment of patency is needed, it is useful for the intracranial bypass surgery.