Article Figures & Data
Figures
- Fig 1.
Schematic sketches of surgical steps, (A–C), intraoperative photographs under the operating microscope (A1–C1), and 2D-DSA (A2–C2) as well as CE-3D-MRA (A3–C3) screen shots of bilobular, bisaccular, and broad-neck aneurysms. A, Bilobular aneurysm. The jugular vein bifurcation stump is anastomosed to the CCA bifurcation, as described in the text and presented in Fig 3. B, Bisaccular aneurysm. Two venous pouches of the left or right external jugular vein are sutured together (white arrow) and anastomosed to the CCA bifurcation. C, Broad-based aneurysm. A 1-cm segment of the left external jugular vein is incised in a longitudinal manner, folded along its transverse axis (1), sutured together proximally (4–5 sutures) and distally (2–3 sutures) (2), and anastomosed to the CCA bifurcation (3).
- Fig 2.
Arterial (red, A) and venous (blue, B) neck vascular anatomy of the rabbit. A, The LCCA is exposed and isolated for a segment of at least 5 cm. The RCCA is dissected distally to its proximal origin at the brachiocephalic trunk (black circle) to achieve a tensionless end-to-side anastomosis of the RCCA to the LCCA (black arrow). B, A 10- to 15-mm segment of the right or left external jugular vein is used for the construction of bisaccluar and broad-neck aneurysms. The internal-external (asterisk) or transverse-external (double asterisks) jugular vein bifurcation serves as a graft for the creation of bilobular aneurysms.
- Fig 3.
Surgical steps of the conventional microsurgical saccular (berry-shaped) venous pouch bifurcation aneurysm model. A, Anastomosis sequences on the back side of the aneurysm (white arrows): 1) The LCCA is sutured to the RCCA. 2) The VP is sutured to the RCCA. 3) The VP is sutured to the LCCA. B, Anastomosis sequences on the front side of the aneurysm (black arrows): 4) The LCCA is sutured to the RCCA. 5) The VP is sutured to the RCCA. 6) The VP is sutured to the LCCA.
- Fig 4.
A, The screenshots illustrate 2D-DSA measurements, including parent vessels and aneurysm length, width, and neck in reference to an external sizing device (highlighted inset boxes). B, The same vessel and aneurysm characteristics are measured in CE-3D-MRA.
Tables
Model/Modality No. Operation Time (min) No. of Sutures RCCA (mm) p-LCCA (mm) d-LCCA (mm) Neck Width (mm) Length/Width Lobule 1 (mm) Length/Width Lobule 2 (mm) Volume (mm3) BL-2DD 1 155 21 3.5 5.7/3.8 5.1/3.8 122.4 BL-3DM 1.9 2.2 2.3 3.6 5.2/3.8 5.4/3.9 123.7 BL-2DD 2 135 27 4.5 8.2/3.6 5.6/3.4 123.7 BL-3DM 2.8 2.6 2.5 4.4 7.3/3.8 5.7/3.2 128.5 BL-2DD 3 170 22 4.3 7.3/3.5 7/3.9 153.4 BL-3DM 2.8 3.2 2.8 4.5 7.1/3.8 7.3/3.9 169.9 BS-2DD 4 189 28 4 8.4/3.9 9.5/3.5 178.6 BS-3DM 2.4 2.4 2.2 3.9 8.3/3.4 8.9/3.6 165.8 BS-2DD 5 190 31 2.9 3.1 3.5 5.4 8.5/4 8.8/4.9 272.6 BS-3DM 3.1 3.4 3.5 5.3 8.6/4.3 8.9/4.5 266.3 BS-2DD 6 160 28 5.2 8.5/5.2 8.2/4.9 335 BS-3DM 2.7 2.9 2.6 5.3 8.6/5.3 8.3/4.6 327.5 BN-2DD 7 140 26 2.8 3.2 2.7 5.9 5.6/8.1 –/– 199.4 BN-3DM 3 3.2 2.8 5.3 5.2/8.7 184.7 BN-2DD 8 185 32 3 3.4 2.7 9.2 4.3/9.5 –/– 137.9 BN-3DM 3 3.6 2.8 8.9 4.7/10.4 180.3 BN-2DD 9 165 27 2.3 2.4 2.1 7.2 4.8/8.3 –/– 150.1 BN-3DM 2.4 2.3 2.3 7.3 4.3/9.3 235 Model/Modality No. Mean Volume (mm3) BL-2DD 1–3 133.2 ± 17.5 BL-3DM 140.7 ± 25.4 BS-2DD 4–5 262.1 ± 78.7 BS-3DM 253.2 ± 81.4 BN-2DD 6–9 162.5.1 ± 32.6 BN-3DM 200 ± 30.4
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