[An evaluation of temporary clipping during aneurysmal surgery: a retrospective study]

Area of Science:

• Neurosurgery
• Vascular Surgery

Context:

• Temporary arterial clipping is a technique used during aneurysm dissection.
• This method controls bleeding and aids in sac collapse.
• However, it carries risks of focal ischemia and neurological deficits.

Purpose:

• To evaluate the impact of temporary clipping on surgical outcomes for ruptured supratentorial aneurysms.
• To analyze the influence of preoperative neurological status (Hunt and Kosnik classification) and operative timing on outcomes.

Summary:

• A retrospective study of 302 patients revealed that those without temporary clipping had better postoperative activity in daily living (ADL) grades (70.7% good) compared to those with clipping (46.4% good).
• For patients with Hunt and Kosnik grade 3, temporary clipping resulted in poor outcomes, whereas no clipping led to good results, indicating grade 3 is a critical factor for clip decision.
• Patients with grades 1-2 generally recovered well, while those with grades 4-5 did not, regardless of clipping.

Impact:

• Findings suggest that avoiding temporary arterial clipping, particularly in Hunt and Kosnik grade 3 patients, may improve surgical outcomes and reduce the incidence of permanent neurological deficits.
• This research informs surgical decision-making for ruptured aneurysms, potentially optimizing patient recovery and functional status.