Temporary Arterial Occlusion for Giant Intracranial Aneurysms

摘要

Temporary arterial occlusion is an invaluable adjunct in the surgical management of giant intracranial aneurysms. The role and usefulness of temporary arterial occlusion during surgical obliteration of intracranial aneurysms are controversial and not generally accepted by all neurosurgeons. Temporary occlusion can be particularly useful in the treatment of giant cerebral aneurysms, which typically require complex vascular reconstructions rather than simple clip application. The benefits of temporary arterial occlusion during aneurysm surgery include: 1) decreased aneurysm turgor during neck dissection; 2) improved aneurysm mobilization; 3) improved visualization of adjacent vasculature; 4) facilitation of clip placement; and 5) decreased incidence of intraoperative aneurysm rupture and more control if this occurs, The possible risks associated with temporary arterial occlusion are related to tissue ischemia and the technical challenge of aneurysm dissection in the presence of multiple temporary aneurysm clips The indications, utility, and limitations of temporary arterial occlusion during the surgical repair of giant intracranial aneurysms are specific to the anatomic location and characteristics of the aneurysm being treated, Over the past 7 years, we have treated over 1100 intracranial aneurysms by microsurgical clip reconstruction, with the majority undergoing some form of temporary arterial occlusion during the surgical procedure. This article will discuss the site-specific indications and limitations of temporary arterial occlusion related to the surgical treatment of giant intracranial aneurysms.