Türk Nöroşirürji Dergisi 2019 , Vol 29 , Num 1
Ischemic Complications Induced by Temporary Clip. In Which Cases? Does Vasospasm Increase These? How Many Minutes? Does Reperfusion Prevent Ischemic Events?
Özhan UÇKUN1,Hilmi Önder OKAY2
1TC Sağlık Bilimleri Üniversitesi Ankara Numune Hastanesi, Beyin ve Sinir Cerrahisi, Ankara, Türkiye
2Erzurum Eğitim ve Araştırma Hastanesi Beyin ve Sinir Cerrahisi Kliniği
Transient clips are sometimes used to control intraoperative aneurysm rupture, but more often to prepare for the permanent clip after aneurysm dissection. A pulsatile aneurysm can only be manipulated with great force, while a softened aneurysm can be easily moved. The most important disadvantage of transient clipping is that it may impair the feeding of the important cerebral area around the aneurysm during deep dissection. Delayed ischemic neurological deficits (DIND) and / or delayed cerebral infarction (DCI) due to cerebral vasospasm are one of the most serious complications of aneurysmal subarachnoid hemorrhage (aSAH). The main provocative agents that generate cerebral vasospasm following aSAH are erythrocytes and disintegration products such as oxiemoglobin. It was also showed that the time between 10 and 20 minutes was the safe transient clip-on time without distinction between elective and rescue temporary clip. The administration of the mean transient clipping time for 19 minutes did not have a negative effect on the clinical outcome. Anahtar Kelimeler : Aneurysm, Transient clip, Vasospasm