The clinical utility of the Kopitnik arteriovenous malformation microclip during STA-MCA bypass surgery.

摘要

PURPOSE: Yasagil temporary clips have been widely used in extracranial-intracranial (EC-IC) arterial bypass surgery. However, the extremely delicate vessels involved often require the application of finer clips. We report on the use of the Kopitnik arteriovenous malformation (AVM) microclip system for superficial temporal artery-middle cerebral artery (STA-MCA) bypass. METHODS: Kopitnik AVM microclips are new mechanical devices that are used during AVM surgery. They exert a pre-defined closing force of 50-70 g, and also feature a special, pyramid-shaped structure stamped on inner surfaces of the blades. These characteristics avoid vascular intimal injury and provide a secure grip. We prospectively studied their use in 15 patients requiring STA-MCA anastomosis. RESULTS: Clinical results were excellent and there were no new ischemic events during 6-months' follow-up. CONCLUSIONS: Kopitnik AVM microclips have several advantages; they have small and variously sized clip blades (2, 3, 4 and 5 mm), and the small clip head allows the operator an excellent view of the pathology and clip status. The Kopitnik AVM microclip appears to be clinically effective and safe for EC-IC bypass surgery, especially when smaller vessels are involved.