Assessment of Cerebral Blood Flow with Micro-Doppler Vascular Reduces the Risk of Ischemic Stroke During the Clipping of Intracranial Aneurysms

作者：Pereira Benedito J A^*; Holanda Vanessa M; Giudicissi Filho Miguel; Borba Luiz Alencar B; de Holanda Carlos Vanderlei M; de Oliveira Jean G

来源：World Neurosurgery, 2015, 84(6): 1747-1751.

DOI：10.1016/j.wneu.2015.07.042

• Cerebral blood flow
• Clipping
• Intracranial aneurysm
• Ischemic stroke
• Micro-Doppler vascular
• Vascular microsurgery

OBJECTIVE: To analyze the impact of the introduction of Micro-Doppler vascular (MDV) as a method of cerebral blood flow analysis during microsurgical clipping of intracranial aneurysms to check the partial occlusion of the aneurysm and the occurrence of stenosis by comparing these results with those provided by the postoperative digital subtraction angiography (DSA) scan as well as the occurrence of ischemic infarction on the postoperative computed tomography (CT) images.
PATIENTS AND METHODS: We reviewed retrospectively the last 50 patients operated on before the introduction of the MDV (group 1) compared with the first 50 patients operated on using this technique (group 2).
RESULTS: Nine (18%) of the 50 patients evaluated in the group 1 showed a new hypodensity in the postoperative CT images, whereas only 2 (4%) patients showed infarction in the group 2 (P = 0.02). In addition, in the group 1, 10 (20%) patients presented unexpected findings on DSA images (residual aneurysms, stenosis, and arterial occlusion), whereas in the group 2, those unexpected DSA findings were observed in only 3 (6%) patients (P = 0.023).
CONCLUSION: MDV is an excellent method for cerebral blood flow assessment during the microsurgical clipping of intracranial aneurysms, reducing the unexpected angiographic results (residual aneurysms, stenosis, and arterial occlusion), as well as reducing the incidence of ischemic infarction on postoperative CT images, evidence of the positive impact of this method in the microsurgical treatment of intracranial aneurysms.

• 出版日期2015-12