gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Deep hypothermia and circulatory arrest for the treatment of complex large and giant cerebral aneurysms – is it still a viable strategy?

Meeting Abstract

  • A. Brawanski - Klinik und Poliklinik für Neurochirurgie, Klinikum der Universität Regensburg
  • M. Proescholdt - Klinik und Poliklinik für Neurochirurgie, Klinikum der Universität Regensburg
  • K.M. Schebesch - Klinik und Poliklinik für Neurochirurgie, Klinikum der Universität Regensburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.15.05

DOI: 10.3205/12dgnc137, URN: urn:nbn:de:0183-12dgnc1376

Published: June 4, 2012

© 2012 Brawanski et al.
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Outline

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Objective: The treatment of complex large and giant aneurysms remains a great challenge in vascular neurosurgery. Besides endovascular strategies, extended skull base approaches and bypass surgery, the clipping of complex aneurismal lesions under deep hypothermia and circulatory arrest (dh/ca) is another promising approach. Here, we present our experience in the surgical treatment of giant and large cerebral aneurysms under deep hypothermia and circulatory arrest.

Methods: Retrospectively, we reviewed the charts of 29 consecutive patients that were treated und dh/ca in our neurosurgical department. We analyzed preoperative condition, preoperative neuroimaging, details of the surgical procedures, peri- and postoperative morbidity and mortality, procedural-related complication rate and neurological outcome.

Results: Subarachnoid hemorrhage led to hospital admission in 38% (n = 11).Twenty patients had complex aneurysms of the anterior circulation and nine patients had complex aneurysms of the posterior circulation. Thrombosis or calcification was found in ten patients. The overall mortality was 9.6%, and the overall morbidity was 17.2%. Ten patients deteriorated transiently but fully recovered.

Conclusions: Still, surgical treatment of complex large and giant aneurysms under dh/ca remains viable in modern and experienced neurosurgical centers. In this respect, the presented study is one of the largest series worldwide. Goals and limitations of dh/ca will be discussed.