Extracorporeal circuit design considerations for giant intracranial aneurysm repair

MacDonald, James; Cleland, Andrew; Mayer, Richard; Henderson, Mark J.

doi:10.1177/026765919701200308

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…There were no operative deaths in this series. Later, many researchers have reported good or excellent outcomes (38)(39)(40). The majority of the more recent reports suggest that a core temperature of 15!…”

Section: Applications In Neurosurgerymentioning

confidence: 99%

Non-cardiac surgery applications of extracorporeal circulation

et al. 2007

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Although the efficacy of extracorporeal circulation (ECC) is well established for open-heart surgery, application of ECC in other surgical areas has not been given much attention. Advances in the related surgical technique and anesthetic management combined with refinements in the ECC procedure itself have encouraged several institutions to use ECC for complex non-cardiac surgeries. ECC is beginning to be used for circulatory support or tissue oxygenation during surgery on the lung, brain, liver, and kidney as well as in emergency situations. With ECC, difficult and complex surgeries can be performed more safely, and the success rate of certain surgeries has been positively affected. It is important that the surgeon, anesthesiologist, and perfusionist are trained in non-cardiac surgery applications of ECC. Thus, we review here non-cardiac uses that have emerged and summarize the related procedures.

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Section: Applications In Neurosurgerymentioning

confidence: 99%

Non-cardiac surgery applications of extracorporeal circulation

et al. 2007

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Anesthetic Management of Deep Hypothermic Circulatory Arrest for Cerebral Aneurysm Clipping

Young

Lawton

Gupta³

et al. 2002

Anesthesiology

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Extracorporeal femoral to carotid artery perfusion in selective brain cooling for a giant aneurysm

Lownie

Menkis²,

Craen³

et al. 2004

Journal of Neurosurgery

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Giant partially thrombosed intracranial aneurysms are a challenge to treat surgically, and they are also unsuitable for coil embolization. The current options for treatment include extracranial-intracranial bypass followed by parent artery occlusion or direct surgical occlusion in which deep hypothermic circulatory arrest is used. The authors report the use of another approach in the treatment of a giant anterior circulation aneurysm: selective brain cooling accomplished by extracorporeal perfusion. This facilitated direct surgery on a 4.2-cm, partially thrombosed aneurysm of the middle cerebral artery (MCA). A brain temperature of 22 degrees C was achieved after 20 minutes of perfusion with blood cooled using an extracorporeal technique of femoral-common carotid artery perfusion. This was followed by a 20-minute period of surgical trapping of the MCA, then evacuation and clip occlusion of the aneurysm. During the period of selective brain cooling the patient's core body temperature was maintained above 35 degrees C. This technique of selective brain cooling may be a useful alternative to currently available surgical and endovascular methods of treatment for giant aneurysms.

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Extracorporeal circuit design considerations for giant intracranial aneurysm repair

Cited by 3 publications

References 7 publications

Non-cardiac surgery applications of extracorporeal circulation

Non-cardiac surgery applications of extracorporeal circulation

Anesthetic Management of Deep Hypothermic Circulatory Arrest for Cerebral Aneurysm Clipping

Extracorporeal femoral to carotid artery perfusion in selective brain cooling for a giant aneurysm

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