Profound hypothermia and circulatory arrest with skull base approaches for treatment of complex posterior circulation aneurysms.

Abstract:

OBJECTIVE:Cardiopulmonary bypass with profound hypothermia and circulatory arrest has seen a resurgence as an adjunct technique in neurological surgery. We report our experience with this technique in treating seven complex vertebro-basilar aneurysms. METHODS:Skull base approaches were used in all cases, providing excellent exposure and minimizing brain retraction. There were six basilar artery aneurysms and one giant fusiform vertebro-basilar artery aneurysm. All aneurysms but one had an apparent neck, which could be clipped. The fusiform vertebro-basilar artery aneurysm was trapped, partially resected, and the circulation was reestablished with a saphenous vein graft from the cervical internal carotid artery to the mid-basilar artery. RESULTS:Five patients had an excellent outcome and two had a good outcome at one year or at latest follow up. Two of the patients showed improvement of neurological deficits which were present before the surgical intervention. CONCLUSION:Applying very strict selection criteria in this small series of patients with posterior circulation aneurysms, excellent or good results were achieved using the profound hypothermic circulatory arrest technique.

journal_name

Acta Neurochir (Wien)

journal_title

Acta neurochirurgica

authors

Sullivan BJ,Sekhar LN,Duong DH,Mergner G,Alyano D

doi

10.1007/s007010050259

subject

Has Abstract

pub_date

1999-01-01 00:00:00

pages

1-11; discussion 11-2

issue

1

eissn

0001-6268

issn

0942-0940

journal_volume

141

pub_type

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