Prevention of ischemic complications during aneurysm surgery

Raabe, Andreas; Seidel, Kathleen (2016). Prevention of ischemic complications during aneurysm surgery. Journal of Neurosurgical Sciences, 60(1), pp. 95-103. Edizione Minerva Medica

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Ischemic complications during aneurysm surgery are a frequent cause of postoperative infarctions and new neurological deficits. In this article, we discuss imaging and neurophysiological tools that may help the surgeon to detect intraoperative ischemia. The strength of intraoperative digital subtraction angiography (DSA) is the full view of the arterial and venous vessel. DSA is the gold standard in complex and giant aneurysms, but due to certain disadvantages, it cannot be considered standard of care. Microvascular Doppler sonography is probably the fastest diagnostic tool and can quickly aid diagnosis of large vessel occlusions. Intraoperative indocyanine green videoangiography is the best tool to assess flow in perforating and larger arteries, as well as occlusion of the aneurysm sac. Intraoperative neurophysiological monitoring with somatosensory and motor evoked potentials indirectly measures blood flow by recording neuronal function. It covers all causes of intraoperative ischemia, provided that ischemia occurs in the brain areas under surveillance. However, every method has advantages and disadvantages. No single method is superior to the others in every aspect. Therefore, it is very important for the neurosurgeon to know the strengths and weaknesses of each tool in order to have them available, to know how to use them for each individual situation, and to be ready to apply them within the time window for reversible cerebral ischemia.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Raabe, Andreas and Seidel, Kathleen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0390-5616

Publisher:

Edizione Minerva Medica

Language:

English

Submitter:

Nicole Söll

Date Deposited:

11 May 2016 15:11

Last Modified:

29 Oct 2019 18:48

PubMed ID:

26606432

BORIS DOI:

10.7892/boris.80138

URI:

https://boris.unibe.ch/id/eprint/80138

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