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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Closed chest hypothermic circulatory arrest for complex intracranial aneurysms
M G Massad1, F T Charbel, R Chaer
1Department of Surgery, The University of Illinois at Chicago, 60612, USA. mmassad@uic.edu
The Annals of Thoracic Surgery
|June 28, 2001
Summary
Closed-chest hypothermic circulatory arrest (CC-HCA) using groin cannulation is a safe, less invasive technique for complex intracranial aneurysms, reducing complications and operative time.
Area of Science:
- Neurosurgery
- Cardiovascular Surgery
- Minimally Invasive Procedures
Background:
- Recent advances in cardiopulmonary bypass enable hypothermic circulatory arrest (HCA) with closed chest (CC-HCA) and groin cannulation.
- This technique avoids direct cardiac access, offering an alternative for complex intracranial aneurysm treatment.
Purpose of the Study:
- To evaluate the safety and efficacy of CC-HCA with groin cannulation for complex intracranial aneurysms.
Main Methods:
- 16 patients with complex intracranial aneurysms underwent CC-HCA via groin cannulation between 1992 and 1999.
- Groin cannulas were placed at aortoiliac and atriocaval junctions; patients were cooled to 16°C nasopharyngeally.
Main Results:
- Mean circulatory arrest time was 32 minutes; no sternotomy conversion was needed.
- 30-day mortality was 12% (2/16 patients). 88% survived with minimal morbidity (e.g., temporary nerve palsy, hemiparesis).
- Two patients developed deep venous thrombosis; all patients showed good long-term outcomes at a mean 42-month follow-up.
Conclusions:
- CC-HCA through groin cannulation is a safe and less invasive approach for complex intracranial aneurysms.
- This technique minimizes sternotomy-related complications, reduces operative time, and facilitates early discharge and rehabilitation.
