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The Nightmare of Aneurysm Surgery: Intraoperative Rupture
1Department of Neurosurgery, Medical Faculty, Hacettepe University, Ankara, Turkey.
World Neurosurgery
|September 23, 2023
Summary
Intraoperative rupture during aneurysm surgery is a critical complication. This case demonstrates successful management of premature rupture using proximal control and clipping techniques.
Area of Science:
- Neurosurgery
- Vascular Surgery
Background:
- Intraoperative rupture (IOR) is a significant complication in aneurysm surgery, occurring at various stages.
- Premature rupture, before aneurysm or parent artery identification, presents unique management challenges.
Observation:
- A case of premature rupture during clipping of an internal carotid artery aneurysm is presented.
- Bleeding occurred during frontal lobe retraction due to adhesions, necessitating immediate action.
Findings:
- The management involved rapid aspiration, temporary clipping of the internal carotid artery, pilot clipping of the aneurysm dome, and definitive clipping of the neck.
- Successful aneurysm occlusion was achieved with a temporary occlusion time of 7 minutes and 40 seconds.
Implications:
- This case underscores the importance of preparedness for intraoperative rupture in aneurysm surgery.
- Reinforces the principle of proximal control as a critical first step in managing such emergencies.
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