Artery-first Approach
Artery-first Approach - Related Videos
10:30
Surgical Approach for Middle Cerebral Artery Occlusion and Reperfusion Induced Stroke in Mice
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Cited by 16 •
2016
In order to understand the pathophysiology of stroke, it is important to use reliable models. This paper will describe one of the most frequently used stroke models in mice, termed the middle cerebral artery occlusion (MCAo) model (also termed the intraluminal filament or suture model) with reperfusion.
06:20
In Vitro Intraluminal Gel Infusion: An Advanced Approach for Microscopic Analysis of Human Resistance Arteries
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2025
Here, we present a protocol for preserving human arterial architecture by infusing tissue-stabilizing gel into the vessel lumen before sectioning for molecular or histopathological analysis.
06:57
Arterial Line Placement
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2023
Source: Sharon Bord, MD, Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Maryland, USA When monitoring patients, it is important to obtain values that are accurate and reliable. Blood pressure monitoring is one of the essential vital signs, and for a majority of patients, measuring it utilizing non-invasive techniques provides accurate values. However, there are situations in which the blood pressure requires more exact, specific, and reliable measurements.
13:10
Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
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Cited by 7 •
2017
Surgical correction of ALCAPA is highly recommended, regardless of age or the degree of intercoronary collateralization. This protocol presents a technique for the direct re-implantation of adult-type ALCAPA into the aorta to re-establish the dual-coronary perfusion. Whenever feasible, direct re-implantation is preferred to other surgical correction techniques.
05:44
Selective and Permanent Occlusion of the Middle Cerebral Artery in Rats: An Experimental Approach for Studying Motor and Spatial Memory Deficits
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2026
The objective of this study was to establish a reproducible method for performing a craniectomy followed by permanent, selective middle cerebral artery occlusion in rats for application in experimental studies of motor and spatial memory deficits.
FAQs
Early exposure of the superior mesenteric artery creates a vascular reference point before dissection reaches the uncinate process. Following the artery’s course allows the surgeon to inspect the relationship between the lesion and the vessel, rather than discovering arterial involvement only after substantial tissue separation. This sequence supports safer planning of the operative plane and may reduce avoidable dissection.
The key decision is whether arterial involvement makes resection unsuitable or requires a modified plan. By assessing the artery before completing dissection, the team can identify disease that could lead to a nonbeneficial resection and reconsider proceeding. In pancreatic cancer surgery, this information is especially important because it links the vascular finding directly to resectability and intended margin planning.
Branch control and plane definition are complementary functions of the approach. Once the artery and its course are understood, vascular branches can be managed while the surgeon establishes the dissection boundary around the uncinate process. This can help preserve uninvolved blood vessels, clarify how the lesion relates to nearby arterial structures, and support removal with a more deliberate margin.
During pancreaticoduodenectomy, the sequence begins with early exposure of the superior mesenteric artery, followed by tracing its course and assessing the adjacent lesion. The surgeon then uses this information to control relevant vascular branches and define the plane around the uncinate process. This sequence turns arterial anatomy into an early checkpoint for resection planning before tissue dissection is completed.
The artery-first approach is particularly relevant during pancreaticoduodenectomy for pancreatic cancer, where arterial involvement can determine whether removal is worthwhile. Early findings help the surgical team avoid completing a resection that is unlikely to benefit the patient, while also informing the intended dissection plane and margin strategy. Its value therefore lies in decision-making before resection is completed.
Assessment can provide three linked types of information: whether the lesion involves a major artery, which vascular branches require control, and where the resection plane should lie near the uncinate process. Together, these findings support blood vessel preservation and more deliberate margin planning. They may also improve the likelihood that tumor removal is complete when resection proceeds.