ArticleNeurosurgery practice2026
A Needle Tip Quality-Controlled Training Protocol for Cerebrovascular End-to-Side Bypass: From Bench to Bedside.
Article in Neurosurgery practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
BACKGROUND AND
objectivesImproper techniques in cerebrovascular end-to-side bypass, such as back-wall injury or skiving bites, can lead to stenosis or thrombosis. To address this challenge, we developed a needle tip quality-controlled (TQC) training protocol and evaluated its training value and clinical significance.
methodsThe TQC protocol mandates continuous visualization of the needle tip within the vessel lumen during each stitch, guided by strict suturing principles that prohibit intraluminal blind suturing. An attending neurosurgeon underwent training using the TQC protocol on a rat femoral vessel model before its clinical application in 26 bypass cases. Cumulative sum analysis was used to assess recipient clamp times during both the animal training and clinical surgeries. Intraoperative and postoperative bypass patency rates were also evaluated.
resultsIn the 24 animal models, the mean recipient clamp time was 30.79 ± 6.42 minutes. Cumulative sum analysis revealed that proficiency required 16 models, after which clamp times significantly decreased to 27.37 ± 5.15 minutes (
conclusionThe TQC protocol effectively prevents technical errors, ensuring high-quality anastomosis. Its high trainability and short learning curve establish it as a practical and valuable training tool for young vascular neurosurgeons.
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