Permissible arterial occlusion time in aneurysm surgery: postoperative hyperperfusion caused by temporary clipping.

Abstract:

:The relationship between hyperperfusion and temporary clipping was evaluated to determine the safe limit for the duration of temporary clipping in aneurysm surgery. Twenty-one patients surgically treated for a ruptured aneurysm were examined using xenon-enhanced computed tomography on postoperative days 4 to 13. Eight of the 16 patients undergoing temporary clipping had focal hyperperfusion; whereas the five patients without temporary clipping had no hyperperfusion. Mean total temporary clipping time in patients with hyperperfusion was significantly longer than that in patients without (31.9 vs. 13.9 minutes, p = 0.0157) and mean maximum single temporary clipping time in patients with hyperperfusion was also significantly longer than in patients without (18.4 vs. 8.6 minutes, p = 0.0313). Moreover, cerebral infarction was related to hyperperfusion (p = 0.0027). These results support the hypothesis that temporary clipping during aneurysm surgery causes postoperative hyperperfusion and cerebral infarction. Temporary clipping may be harmful when performed for more than 20 minutes of total duration, since postoperative hyperperfusion was seen under this condition.

authors

Araki Y,Andoh H,Yamada M,Nakatani K,Andoh T,Sakai N

doi

10.2176/nmc.39.901

keywords:

subject

Has Abstract

pub_date

1999-12-01 00:00:00

pages

901-6; discussion 906-7

issue

13

eissn

0470-8105

issn

1349-8029

pii

JST.Journalarchive/nmc1959/39.901

journal_volume

39

pub_type

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