Summary:
Temporary clipping in aneurysm surgery has been used more frequently in recent years to increase the
efficacy and safety of the neck dissection and obliteration.Experimental studies showed that neuro-
protection using hypertension and mannitol administration diminishes the risk of ischaemia during
this procedure.Recent studies show,however,that this method has to be used with caution.In a recent
series of 85 aneurysms we used temporary vessel occlusion with neuroprotection described above in
17 patients (20 %),ranging from 2 to 35 minutes.The indication was peroperative rupture (3 cases),
difficult neck dissection (13 cases)and a giant aneurysm (1 case).14 of these patients had good results,
one was severely disabled,the other 2 died.One of them had a large temporal haematoma and was HH
V before the operation,the other one had a premature peroperative aneurysm rupture.The postope-
rative infarction rate was similar in the group of patients with temporary clipping (17 %)and without
it (15 %).We conclude that temporary clipping in aneurysm surgery is a relatively safe procedure which
facilitates the aneurysm neck dissection and enables neck obliteration in difficult cases.Better results
are achieved with shorter duration of occlusion.
Key words:
temporary clip,aneurysm,brain ischaemia
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