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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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The impact of temporary clipping during aneurysm surgery on cerebral vasospasm in 632 patients with aneurysmal subarachnoid hemorrhage

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  • Vesna Malinova - Department of Neurosurgery, Göttingen; Department of Neurosurgery, Aachen
  • Veit Rohde - Department of Neurosurgery, Göttingen; Department of Neurosurgery, Aachen
  • Dorothee Wachter - Department of Neurosurgery, Göttingen; Department of Neurosurgery, Aachen

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMI.12.08

doi: 10.3205/13dgnc382, urn:nbn:de:0183-13dgnc3826

Published: May 21, 2013

© 2013 Malinova et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Cerebral vasospasm and delayed ischemic neurological deficits (DIND) are the leading causes of death and disability after aSAH. In contrast to endovascular coiling, aneurysm surgery has been assumed to potentially increase the risk for cerebral vasospasm. As temporary clipping of the parent vessel represents a distincitve way of intraoperative manipulation, it might increase the risk for vasospasm in patients even more. Aim of this study was to evaluate the impact of temporary clipping during aneurysm surgery on the incidence of cerebral vasospasm after aSAH.

Method: We analyzed a database of 1016 patients suffering from aSAH. 632 patients had complete data documentation concerning intraoperative temporary clipping and cerebral vasospasm. Cerebral vasospasm was diagnosed by transcranial Doppler sonography and defined by a maximum mean blood flow velocities of >120cm/s. Mann Whitney U Test was applied to evaluate the correlation between temporary clipping and cerebral vasospasm.

Results: Mean age of patients was 53.8 years (range 16-86). 422 of the patients were female, 221 male. 44.8% (284/632) of the patients developed cerebral vasospasm. In 47.7% (302/632) temporary clipping was performed during aneurysm surgery. We found no significant correlation between intraoperative temporary clipping and the incidence of cerebral vasospasm (p=0.18).

Conclusions: Temporary clipping during aneurysm surgery does not increase the incidence of cerebral vasospasm in patient suffering from aSAH during the postoperative period. In consequence, it has to be questioned if surgery per se is a contributor to vasospasm.