Aneurysms of the Basilar Artery Treated with Circulatory Arrest , Hypothermia and Barbiturate Cerebral Protection - 2 cases - / 대한마취과학회지

Surgical and anesthetic management in patients with complex vascular lesions is often challenging. Cardiopulmonary bypass followed by total circulatory arrest, deep hypothermia and barbiturate cerebral protection are efficacious adjuncts in the surgical treatment of giant basilar artery aneurysm. These techniques were utillized in two large basilar artery aneurysm patients with good results, and the surgical and anesthetic considerations are reviewed.

A Case of Giant Intracranial Aneurysm Treated with Total Circulatory Arrest, Hypothermia, and Barbiturate Cerebral Protection

We are reporting a case of giant intracranial aneurysm operated under circulatory arrest. The patient was a 36-year-old woman with right hemiparesis and dysarthria. Brain MRI and angiographgy disclosed a partially thrombosed, dumbbell-shaped giant aneurysm involving the left distal ICA and M1 portion of the MCA. The patient was treated with direct clipping under total circulatory arrest, hypothermia, and barbiturate cerebral protection. The clipping could be done more easily than with conventional methodology because the aneurysm was softened. But the patient didn't recover due to postoperative intracerebral hemorrhage and possible embolic infarct.