Transient Arterial Stenosis at the Site of Temporary Clipping and Vasospasm Distal to It

ABSTRACT

The authors studied for 20 operated cases of aneurysm which was able to follow-up examination of Transcranial dopple sean. In these patients, we performed temporary clippings at the proximal sites of aneurysms in 12 cases(TC group) and the other 8 patients wre not performed(non-TC group). Trascranial Doppler and Digital Subtraction Angiography was performed at preoperative and postoperative period at all patients. We found that transient arterial stenosis was detected at the site of prolonged temporary clipping(45 min due to premature rupture) by TCD and DSA in 1 case. It was at the supraclinoid portion of ICA and the patient had single right MCA aneurysm. The preoperative vassopasm had been found in 4 cases, subclinical in 3 cases and transientl motor weakuess in 1 case. The postoperative vasospasm occurred in 6 cases of TC group(2 clinical), and no case in non-TC group. There were 1 case of left A1, 5 cases left M1 and 2 cases of right M1, 3 cases of left ICA and 1 case of right ICA. There was no close relationship between the findings of TCD and DSA, and the spastic range of vasospasm was above 150cm/sec by TCD. Thus temporary clipping tends to increase the incidence of postoperative vasospasm, and rather definite after long duration of its application. The anierial stenosis was transient.