Article
Temporary clipping seems to affect the incidence of vasospasm after SAH
Das temporäre Clipping scheint einen Vasospasmus provozieren zu können
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Published: | April 23, 2004 |
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Outline
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Objective
Patients with large volume SAH are more likely to develop vasospasm after aneurysmatic SAH. Information about the role of surgery and temporary clipping concerning the development of vasospasm is sparse. The aim of this study was therefore to gather more information in this field.
Methods
From 1995 to 2000 we operated on 292 patients (50.6 years mean, 64.4% females) with aneurysmatic SAH. The data were collected in a prospective databank, which included information on severity of SAH, radiological data and operative procedures like temporary clipping. In addition, we registrated TCD data on a daily basis. All patients had a follow-up after 2-3 month according the Glasgow outcome scale (GOS).
Results
Severity according to the WFNS grading and vasospasm correlated significantly to outcome (p<0.0001). The Fisher rating scale significantly correlated to the development vasospasm detected by TCD (> 120 cm/s, p<0.0001). 50.5% of the patients had temporary clipping during surgery. Temporary clipping significantly correlated to the development of vasospasm (63.3% developed vasospasm, p<0.008;). Temporary clipping was significantly more often applied in aneurysms of the arteria cerebri media (p<0.0001) and vasospasm was detected more frequently in this area (p<0.004). In patients with unfavourable outcome there was a tendency for longer clipping times (3.2 versus 2.1 min, mean, p=0.06).
Conclusions
Temporary clipping during surgery seems to be able to provoke vasospasm after aneurysmatic SAH.