On temporary clipping in cerebral aneurysm surgery (literature review).

Abstract

Temporary clipping (TC) of the parent artery is a standard procedure in cerebral aneurysm surgery. According to a number of studies, TC lasting up to 5 minutes is safe in terms of the development of ischemic complications. In cases where a longer TC is required, it is recommended to alternate vessel shutdown with periods of reperfusion, which allows the procedure to be repeated many times without the risk of ischemia. The article presents a review of current scientific publications on TC in cerebral aneurysm surgery, showing that this is a very unpredictable procedure in terms of the development of complications, even when performed within the recommended time parameters. There are cases of ischemia with TC lasting less than 5 minutes and the opposite situation, when TC lasting more than 10–20 minutes does not lead to the development of complications. The review also presents current ideas on how to improve the safety of TC, including the use of intraoperative neurophysiological monitoring.