The rubber dam interposition technique during intracranial aneurysm clipping under deep hypothermic circulatory arrest.

摘要

OBJECTIVE: We describe a technique for isolating perforating arteries by use of a rubber sheet during the clipping of intracranial aneurysms under deep hypothermic circulatory arrest. METHODS: After meticulous dissection of the perforating arteries from the aneurysm, a rubber sheet, cut from a surgical glove to the proper shape, is inserted between the aneurysm and the arteries to prevent arterial reattachment to the aneurysmal neck. RESULTS: Even when perforators are invisible at the time of neck clipping because of a large aneurysmal body, the blade of the clip slides along the rubber sheet without injuring the vessels. CONCLUSION: With this method, an aneurysm, especially a large or giant one, can be clipped easily and safely even when the patient is in deep hypothermic circulatory arrest.