2020 Online Salon
Mitigating Ischemia In Combination Bypasses
Project Details
- Entrant Name: Kristen Larson Keil
- Membership Type: Professional Submission
- Address: Phoenix, Arizona USA
- Client: Fabio Frisoli, MD and Michael Lawton, MD
- Copyright: 2020 Barrow Neurological Institute
- Medium/software used: Adobe Photoshop
- Final presentation format: Print and Web
- Primary Audience: Neuroscience professionals
Project Description
These illustrations were created to supplement the text of a medical journal article describing a novel method for revascularizing trapped middle cerebral artery (MCA) bifurcation aneurysms. One of the dangers of this kind of double bypass is prolonged ischemia during multiple periods of temporary occlusion. These figures illustrate a method that can mitigate those ischemic dangers. In this example, once the M2 inferior trunk is occluded distal to the aneurysm, it is revascularized via a bypass from adjacent circulation. The proximal segment of the artery between the distal trapping clip and the anastomosis is a dead end (B). This segment was repurposed as a live end (C) that can then be joined with the M2 superior trunk while the M2 inferior trunk territory distal to the temporary clip remains fully vascularized. This allows an anastomosis between the superior and inferior vessels (either end-to-side or end-to-end) while ensuring only one trunk’s territory is occluded at any one time.
