title: Temporary bilateral external carotid artery clamping to reduce blood loss during removal of calvarial meningioma: a technical note.
abstract: OBJECTIVE
  Large calvarial lesions may bleed extensively during their removal. The main vascular supply to such lesions is from branches of the external carotid arteries (ECAs). Bilateral ECA embolisation has been described to reduce the vascularity, and therefore blood loss of such lesions during their surgical removal, but it is expensive and not easily available in developing countries. In addition, it is associated with significant morbidity.
  
  
  METHODS
  A case of a large calvarial meningioma, extending across the midline is presented in which both external carotids were temporarily clamped to reduce blood loss. Blood loss was low and the complications of permanent occlusion of the arteries avoided.
  
  
  CONCLUSIONS
  This technique can be used for vascular calvarial lesions extending across the midline where embolisation is not feasible or has failed.
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.
authors.forename: Kanchan K
authors.initials: KK
authors.lastname: Mukherjee
authors.forename: Pravin
authors.initials: P
authors.lastname: Salunke
authors.forename: Rajesh
authors.initials: R
authors.lastname: Chhabra
authors.forename: Sachin
authors.initials: S
authors.lastname: Adhikari
authors.forename: Neerja
authors.initials: N
authors.lastname: Bharti
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002342:Carotid Artery, External; D003250:Constriction; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000098:blood supply / Q000601:surgery*; D008579:Meningioma / Q000098:blood supply / Q000601:surgery*; D008875:Middle Aged; D016896:Treatment Outcome