Temporary clipping during early operation for ruptured aneurysm: preliminary report

Area of Science:

• Neurosurgery
• Vascular Surgery
• Neuroradiology

Background:

• Aneurysm surgery requires careful management of blood flow.
• Temporary arterial occlusion is a technique used during complex aneurysm clipping.
• Potential risks include arterial damage and thromboembolic events.

Purpose of the Study:

• To evaluate the safety and efficacy of temporary arterial occlusion in early aneurysm operations.
• To assess for angiographically detectable arterial wall changes post-occlusion.
• To determine the incidence of thromboembolic complications associated with temporary clipping.

Main Methods:

• Temporary arterial occlusion was performed in 16 patients undergoing surgery for ruptured middle cerebral artery (MCA) or anterior communicating artery aneurysms.
• Occlusion was used due to premature rupture, to facilitate dissection, or to aid clipping.
• Patients were monitored for arterial wall changes and thromboembolic events.

Main Results:

• Temporary occlusion did not lead to angiographically detectable arterial wall changes.
• No increased thromboembolic complications were observed with standard aneurysm clips.
• Temporary clipping of MCA aneurysms up to 20 minutes was well tolerated.
• Occlusion of anterior cerebral arteries or pericallosal clipping did not invariably lead to adverse outcomes.

Conclusions:

• Temporary arterial occlusion using standard aneurysm clips is a safe adjunct in early aneurysm surgery.
• The technique can be employed for MCA, anterior communicating artery, and related aneurysms without significant complications.
• Careful application and duration are key to successful outcomes in acute aneurysm operations.