A METHOD OF INTRAVASCULAR ASPIRATION OF BLOOD IN SURGERY OF BIG AND GIANT PARACLINOID ANEURYSMS
Yu.M. Filatov, Sh.Sh. Eliava, A.S. Kheyreddin, V.N. Kornienko, O.B. Sazonova, A.Yu. Lubnin, O.F. Tropinskaya
Burdenko Research Institute of Neurosurgery
The purpose: Evaluation of efficacy of a method of intravascular aspiration of blood (IAB) from aneurysms in patients with big and giant paraclinoid aneurysms of ICA.
Methods: The analysis of treatment of 17 patients with big and giant paraclinoid aneurysms of ICA is given. The method of IAB is described. Clipping of a neck of aneurysm was performed in all patients with the help of IAB.
Results: Control angiography showed that there was complete and partial clliping in 12 and 2 patients respectively. Aneurysms were wrapped with surgical gauze in 2 cases. Incompetent clipping was watched in 1 patient. Recovery, improvement and aggravation of a state were observed in 14, 2 and 1 cases respectively. There were no fatal outcomes.
Conclusion: The above method is indicated in big and giant thin-walled thrombus-free aneurysms of the paraclinoid segment of ICA. It allows to exercise effective proximal control over blood flow in ICA and creates favourable conditions for early prognostication and prevention of ischemic complications. Fractional IAB supported by intraoperative monitoring makes this method effective even in case of inadequate collateral circulation.