Running-to-Interrupted Microsuture Technique for Vascular Bypass.

BACKGROUND: The ideal suturing technique for microvascular anastomosis for neurosurgical bypass procedures remains a point of debate. Simple interrupted sutures are thought to possess higher long-term patency but require more time to place as compared to running sutures.

OBJECTIVE: To optimize the efficiency of microvascular anastomosis and limit brain ischemia time.

METHODS: The running-to-interrupted microsuture technique, a modification of the previously published spiral anastomosis, is described wherein loosely thrown running sutures are placed between 2 opposed anchor stitches. The loops are then serially cut and tied, resulting in efficiently placed interrupted stitches. This process is repeated on the opposite side to complete the anastomosis.

RESULTS: The running-to-interrupted microsuture technique is quickly learned, limits unnecessary microsurgical movements, and is employed by the senior author for a multitude of cerebral arterial bypass procedures.

CONCLUSION: This technical improvement can be adapted by any neurovascular surgeon to optimize microsurgical efficiency and limit anastomosis-related brain ischemia times.