Cargando…

High-flow bypass and wrap-clipping for ruptured blood blister-like aneurysm of the internal carotid artery using intraoperative monitoring of cerebral hemodynamics

Aneurysms at non-branching sites in the supraclinoid internal carotid artery (ICA) can be classified as “blood blister-like aneurysms” (BBAs), which have blood blister-like configurations and fragile walls. While surgical treatment for the BBA in the acute stage is recommended, the optimal surgical...

Descripción completa

Detalles Bibliográficos
Autores principales: Kubo, Yoshitaka, Koji, Takahiro, Yoshida, Kenji, Saito, Hideo, Ogawa, Akira, Ogasawara, Kuniaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461015/
https://www.ncbi.nlm.nih.gov/pubmed/26082641
http://dx.doi.org/10.2147/VHRM.S73779
_version_ 1782375475055689728
author Kubo, Yoshitaka
Koji, Takahiro
Yoshida, Kenji
Saito, Hideo
Ogawa, Akira
Ogasawara, Kuniaki
author_facet Kubo, Yoshitaka
Koji, Takahiro
Yoshida, Kenji
Saito, Hideo
Ogawa, Akira
Ogasawara, Kuniaki
author_sort Kubo, Yoshitaka
collection PubMed
description Aneurysms at non-branching sites in the supraclinoid internal carotid artery (ICA) can be classified as “blood blister-like aneurysms” (BBAs), which have blood blister-like configurations and fragile walls. While surgical treatment for the BBA in the acute stage is recommended, the optimal surgical procedure remains controversial. In the study reported here, we describe the case of a 37-year-old woman with a ruptured BBA in the ophthalmic segment of the right ICA who underwent wrap-clipping with external carotid artery–internal carotid artery bypass by intraoperative estimation of the measurement of cortical cerebral blood flow (CoBF) using a thermal diffusion flow probe. Trapping of the ICA in the acute stage of subarachnoid hemorrhage may result in ischemic complications secondary to hemodynamic hypoperfusion or occlusion of the perforating artery, and/or delayed vasospasm, even with concomitant bypass surgery. We believe that it is important to perform scheduled external carotid artery–internal carotid artery bypass before trapping of the ICA in patients with a ruptured BBA in the acute stage of subarachnoid hemorrhage and to perform wrap-clipping rather than trapping. This would provide much more CoBF if a reduction of CoBF occurs after trapping occlusion of the ICA including a ruptured BBA according to intraoperative CoBF monitoring. As far as we are aware, the case reported here is the first report on high-flow bypass and wrap-clipping for a ruptured BBA of the ICA using intraoperative monitoring of cerebral hemodynamics.
format Online
Article
Text
id pubmed-4461015
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-44610152015-06-16 High-flow bypass and wrap-clipping for ruptured blood blister-like aneurysm of the internal carotid artery using intraoperative monitoring of cerebral hemodynamics Kubo, Yoshitaka Koji, Takahiro Yoshida, Kenji Saito, Hideo Ogawa, Akira Ogasawara, Kuniaki Vasc Health Risk Manag Case Report Aneurysms at non-branching sites in the supraclinoid internal carotid artery (ICA) can be classified as “blood blister-like aneurysms” (BBAs), which have blood blister-like configurations and fragile walls. While surgical treatment for the BBA in the acute stage is recommended, the optimal surgical procedure remains controversial. In the study reported here, we describe the case of a 37-year-old woman with a ruptured BBA in the ophthalmic segment of the right ICA who underwent wrap-clipping with external carotid artery–internal carotid artery bypass by intraoperative estimation of the measurement of cortical cerebral blood flow (CoBF) using a thermal diffusion flow probe. Trapping of the ICA in the acute stage of subarachnoid hemorrhage may result in ischemic complications secondary to hemodynamic hypoperfusion or occlusion of the perforating artery, and/or delayed vasospasm, even with concomitant bypass surgery. We believe that it is important to perform scheduled external carotid artery–internal carotid artery bypass before trapping of the ICA in patients with a ruptured BBA in the acute stage of subarachnoid hemorrhage and to perform wrap-clipping rather than trapping. This would provide much more CoBF if a reduction of CoBF occurs after trapping occlusion of the ICA including a ruptured BBA according to intraoperative CoBF monitoring. As far as we are aware, the case reported here is the first report on high-flow bypass and wrap-clipping for a ruptured BBA of the ICA using intraoperative monitoring of cerebral hemodynamics. Dove Medical Press 2015-06-03 /pmc/articles/PMC4461015/ /pubmed/26082641 http://dx.doi.org/10.2147/VHRM.S73779 Text en © 2015 Kubo et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Case Report
Kubo, Yoshitaka
Koji, Takahiro
Yoshida, Kenji
Saito, Hideo
Ogawa, Akira
Ogasawara, Kuniaki
High-flow bypass and wrap-clipping for ruptured blood blister-like aneurysm of the internal carotid artery using intraoperative monitoring of cerebral hemodynamics
title High-flow bypass and wrap-clipping for ruptured blood blister-like aneurysm of the internal carotid artery using intraoperative monitoring of cerebral hemodynamics
title_full High-flow bypass and wrap-clipping for ruptured blood blister-like aneurysm of the internal carotid artery using intraoperative monitoring of cerebral hemodynamics
title_fullStr High-flow bypass and wrap-clipping for ruptured blood blister-like aneurysm of the internal carotid artery using intraoperative monitoring of cerebral hemodynamics
title_full_unstemmed High-flow bypass and wrap-clipping for ruptured blood blister-like aneurysm of the internal carotid artery using intraoperative monitoring of cerebral hemodynamics
title_short High-flow bypass and wrap-clipping for ruptured blood blister-like aneurysm of the internal carotid artery using intraoperative monitoring of cerebral hemodynamics
title_sort high-flow bypass and wrap-clipping for ruptured blood blister-like aneurysm of the internal carotid artery using intraoperative monitoring of cerebral hemodynamics
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461015/
https://www.ncbi.nlm.nih.gov/pubmed/26082641
http://dx.doi.org/10.2147/VHRM.S73779
work_keys_str_mv AT kuboyoshitaka highflowbypassandwrapclippingforrupturedbloodblisterlikeaneurysmoftheinternalcarotidarteryusingintraoperativemonitoringofcerebralhemodynamics
AT kojitakahiro highflowbypassandwrapclippingforrupturedbloodblisterlikeaneurysmoftheinternalcarotidarteryusingintraoperativemonitoringofcerebralhemodynamics
AT yoshidakenji highflowbypassandwrapclippingforrupturedbloodblisterlikeaneurysmoftheinternalcarotidarteryusingintraoperativemonitoringofcerebralhemodynamics
AT saitohideo highflowbypassandwrapclippingforrupturedbloodblisterlikeaneurysmoftheinternalcarotidarteryusingintraoperativemonitoringofcerebralhemodynamics
AT ogawaakira highflowbypassandwrapclippingforrupturedbloodblisterlikeaneurysmoftheinternalcarotidarteryusingintraoperativemonitoringofcerebralhemodynamics
AT ogasawarakuniaki highflowbypassandwrapclippingforrupturedbloodblisterlikeaneurysmoftheinternalcarotidarteryusingintraoperativemonitoringofcerebralhemodynamics