Anesthetic management for clipping giant intracranial basilar artery aneurysm under deep hypothermic circulatory arrest / 第三军医大学学报

ABSTRACT

Objective To study the performance of deep hypothermic circulatory arrest and the anesthestic management for giant intracranial basilar artery aneurysm. Methods Seven patients undergoing resection of giant intracranial basilar artery aneurysm were included in the study. By monitoring cerebral oximetry (rSO_2), body temperature and electrocardiogram (ECG), brain and other vital organs were guaranteed to maintain oxygen supply/demand balance in perioperative management, especially during the circulatory arrest period under deep hypothermia. The measured parameters, the outcome of patients and the complications were observed and recorded. Results Even in profound hypothermic condition, rSO_2 was degraded significantly during circulatory arrest, and recovered after in circuit. Low flow perfusion maintained cerebral oxygen supply/demand balance better than circulatory arrest. In all 7 cases, cerebral anoxia caused by circulation arrest after operation were not observed. Conclusion Deep hypothermic circulation arrest could be applied effectively in the resection of giant intracranial basilar artery aneurysm with brain protective measure and monitoring. To improve the outcomes of the patients, avoiding cerebral anoxia and of local vessel injuries is important.