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Journal of Korean Neurosurgical Society 1992;21(2): 234-241.
Posterior Circulation Aneurysms Treated with Circulatory Arrest, Hypothermia and Barbiturate:3 Cases.
Yang Kwon, Chang Jin Kim, Seung Chul Rhim, Byung Duk Kwun, C Jin Whang, Sam Hyun Kim, Yun Mi Hwang, Seung Min Han
1Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
2Department of Chest Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
3Department of Neurology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
4Department of Neuroanesthesiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
ABSTRACT
Direct approach of technically difficult or inoperable intracranial aneurysms many become possible using complete circulatory arrest with extracorporeal circulation and profound hypothermia and barbiturate cerebral protection. To avoid difficulties associated with closed chest method, open chest method was used by direct cannulation of the right atrium and aorta through the chest. 3 patients with posterior circulation aneurysms operated on with these techniques;1 large basilar bifurcation aneurysm and 1 irregular shaped vertebro-basilar junction aneurysm and 1 posterior cerebral artery aneurysm were operated on and all had excellent results. Careful attention was needed to the depth of hypothermia, duration of total circulatory arrest, and hemostasis which important factors in the success of these methods.
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