On temporary clipping in cerebral aneurysm surgery (literature review).

P. G. Shnyakin, A. V. Botov, A. S. Loseva
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Abstract

Temporary clipping (TC) of the parent artery is a standard procedure in cerebral aneurysm surgery. According to a number of studies, TC lasting up to 5 minutes is safe in terms of the development of ischemic complications. In cases where a longer TC is required, it is recommended to alternate vessel shutdown with periods of reperfusion, which allows the procedure to be repeated many times without the risk of ischemia. The article presents a review of current scientific publications on TC in cerebral aneurysm surgery, showing that this is a very unpredictable procedure in terms of the development of complications, even when performed within the recommended time parameters. There are cases of ischemia with TC lasting less than 5 minutes and the opposite situation, when TC lasting more than 10–20 minutes does not lead to the development of complications. The review also presents current ideas on how to improve the safety of TC, including the use of intraoperative neurophysiological monitoring.
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脑动脉瘤手术中的临时夹持(文献复习)。
临时夹闭(TC)的母动脉是一个标准的程序在脑动脉瘤手术。根据多项研究,就缺血性并发症的发生而言,持续5分钟的TC是安全的。在需要更长的TC的情况下,建议将血管关闭与再灌注交替进行,这使得该过程可以重复多次而不会有缺血的风险。本文回顾了目前关于脑动脉瘤手术中TC的科学出版物,表明即使在推荐的时间参数内进行TC手术,其并发症的发展也是非常不可预测的。有缺血时TC持续时间小于5分钟的病例,也有相反情况,TC持续时间大于10-20分钟时不发生并发症。这篇综述还介绍了目前关于如何提高TC安全性的想法,包括术中神经生理监测的使用。
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