Management of difficult intracranial aneurysms by deep hypothermia and elective cardiac arrest using cardiopulmonary bypass.

Abstract:

:Giant anterior circulation aneurysms and some basilar aneurysms can cause problems due to their size, the presence of clot in the aneurysm and the difficulty of applying a clip without kinking the perforating vessels. By utilising cardiopulmonary bypass via the femoro-femoral perforating vessels. By utilising cardiopulmonary bypass via the femoro-femoral route the patient can be cooled to below 20 degrees C allowing the circulation to be stopped for up to 3/4 hour. This will enable the neurosurgeon to unhurriedly dissect out the aneurysm without fear of rupture and where necessary open the aneurysm to remove clot and clip the aneurysm. By draining the circulating volume into the venous reservoir of the pump, a large aneurysm may collapse thus enabling it to be clipped more easily. It is, therefore, a useful technique for difficult aneurysms. We present here a series of 11 patients who underwent this procedure with excellent results in 7. All patients had aneurysms which would otherwise have been either inoperable or very risky to tackle.

journal_name

Br J Neurosurg

authors

Richards PG,Marath A,Edwards JM,Lincoln C

doi

10.3109/02688698709035310

subject

Has Abstract

pub_date

1987-01-01 00:00:00

pages

261-9

issue

2

eissn

0268-8697

issn

1360-046X

journal_volume

1

pub_type

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