Permissible Arterial Occlusion Time in Aneurysm Surgery: Postoperative Hyperperfusion Caused by Temporary Clipping

Yuzo ARAKI, Hiromichi ANDOH, Mikito YAMADA, Kei NAKATANI, Takashi ANDOH, Noboru SAKAI
1999 Neurologia medico-chirurgica  
The relationship between hyperperfusion and temporary clipping was evaluated to determine the safe limit for the duration of temporary clipping in aneurysm surgery. Twenty-one patients surgically treated for a ruptured aneurysm were examined using xenon-enhanced computed tomography on postoperative days 4 to 13. Eight of the 16 patients undergoing temporary clipping had focal hyper perfusion; whereas the five patients without temporary clipping had no hyperperfusion. Mean total temporary
more » ... g time in patients with hyperperfusion was significantly longer than that in pa tients without (31.9 vs. 13.9 minutes, p = 0.0157) and mean maximum single temporary clipping time in patients with hyperperfusion was also significantly longer than in patients without (18.4 vs. 8.6 minutes, p = 0.0313). Moreover, cerebral infarction was related to hyperperfusion (p = 0.0027). These results support the hypothesis that temporary clipping during aneurysm surgery causes post operative hyperperfusion and cerebral infarction. Temporary clipping may be harmful when per formed for more than 20 minutes of total duration, since postoperative hyperperfusion was seen under this condition.
doi:10.2176/nmc.39.901 pmid:10658450 fatcat:2m22hxv4ofcthesr6utqrbylmi