Deep Hypothermia and Circulatory Arrest in the Giant MCA Aneurysm Surgery

ABSTRACT

Despite significant advances in neurosurgical and neuroanesthetic techniques, certain lesions such as giant aneurysms still present significant challenge to neurosurgoens. The authors experienced a case of giant MCA bifurcation aneurysm surgery using a technique of deep hypothermia and circulatory arrest with excellent outcome. Cannulation for cardiopulmonary bypass can be done either centrally through a sternotomy(aortic-right atrial), or peripherally through a small inguinal incision(femoral-femoral). In our case, femoral-femoral cannulation was done which can eliminate many serious complications following the sternotomy. The rationale for the application of the deep hypothermia and circulatory arrest in the complex intaracranial aneurysm surgery and the benefits of the femoral cannulation are disccused.