Novel Use of Robotically Harvested Internal Thoracic Artery in High-Flow Cerebral Bypass

Mario Zanaty; Shravan Atluri; Benedict Taylor; Ondrej Choutka

doi:10.1016/j.wneu.2023.06.142

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Novel Use of Robotically Harvested Internal Thoracic Artery in High-Flow Cerebral Bypass

Journal article

Peer reviewed

Novel Use of Robotically Harvested Internal Thoracic Artery in High-Flow Cerebral Bypass

Mario Zanaty, Shravan Atluri, Benedict Taylor and Ondrej Choutka

World neurosurgery, Vol.178, pp.52-52

10/01/2023

DOI: 10.1016/j.wneu.2023.06.142

PMID: 37422189

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Abstract

Mesenchymal tumors of the head and neck can lead to tumor-induced osteopeni, necessitating a biochemical cure to alleviate associated symptoms. We present a case of a 40-year-old man who presented with diffuse pain and wheelchair dependency secondary to a skull base mesenchymal tumor producing tumor-induced osteopeni. The tumor involved the cavernous sinus, infratemporal fossa, and middle cranial fossa. The patient failed the balloon occlusion test. Additionally, the patient consented to the procedure. Cerebral revascularization was performed using a robotically harvested internal thoracic artery because of the patient's short radial arteries and history of chronic superficial and deep vein thrombosis. After the common carotid artery−internal thoracic artery−M2 bypass, the patient underwent endovascular embolization of the external carotid artery feeders and occlusion of the cavernous external carotid artery. Several days later, the patient underwent a gross total resection via endoscopic assisted microsurgery. The residual biochemical disease was then addressed via supplemental radiosurgery. The patient's clinical outcome was favorable, with regained ambulatory function and resolution of initial symptoms. Unfortunately, he developed left optic neuropathy due to the embolization of the external carotid artery feeders.

Cerebral revascularization

High-flow bypass

Internal mammary artery

Internal thoracic artery

Details

Title: Subtitle: Novel Use of Robotically Harvested Internal Thoracic Artery in High-Flow Cerebral Bypass
Creators: Mario Zanaty - University of Iowa
Shravan Atluri - Saint Alphonsus Health System
Benedict Taylor - Saint Alphonsus Health System
Ondrej Choutka - Saint Alphonsus Health System
Resource Type: Journal article
Publication Details: World neurosurgery, Vol.178, pp.52-52
DOI: 10.1016/j.wneu.2023.06.142
PMID: 37422189
NLM abbreviation: World Neurosurg
ISSN: 1878-8750
eISSN: 1878-8769
Publisher: Elsevier Inc
Language: English
Date published: 10/01/2023
Academic Unit: Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984526360102771

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