[Two cases of clipping surgery of cerebral aneurysm under profound hypothermia with closed-chest extracorporeal circulation].
A 68-year-old female and a 47-year-old male patients underwent clipping surgery for giant basilar arterial and thrombotic internal carotid arterial aneurysms respectively with closed-chest extracorporeal circulation (femoro-femoral bypass). Profound hypothermia and continuous infusion of thiamylal were used to prevent brain damage. Blood outflow via the femoral vein was sufficient to induce profound hypothermia down to 20 degrees C. Hemodynamics were controllable without catecholamines during closed-chest extracorporeal circulation. Preoperative symptoms significantly improved and no neurological complication was observed in either case postoperatively. Right femoral phlebothrombosis was, however, observed in one case. In conclusion, profound hypothermia with closed-chest extracorporeal circulation is a safe technique to reduce the complications induced by open-chest technique, but special attention should be given to postoperative phlebothrombosis.
Homma
Y
Y
Department of Anesthesiology, Sapporo Medical University, School of Medicine.
Yamakage
M
M
Tsuchida
H
H
Kawama
S
S
Namiki
A
A
D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001488:Basilar Artery / Q000601:surgery; D001925:Brain Damage, Chronic / Q000517:prevention & control; D002343:Carotid Artery, Internal / Q000601:surgery; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D013840:Thiamylal / Q000008:administration & dosage; D013924:Thrombophlebitis / Q000517:prevention & control
D018686:Anesthetics, Intravenous; D013840:Thiamylal