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Japanese

Therapeutic Occlusion of Unilateral Vertebral Artery for Unclippable Aneurysms; Special reference to postoperative brainstem ischemia Toshihiro YASUI 1 , Hisatsugu YAGURA 1 , Masaki KOMIYAMA 1 , Yoshihiko Fu 1 , Yasunori NAGATA 1 , Katsuhiko TAMURA 1 , Anmyong KIM 1 1Department of Neurosurgery, Baba Memorial Hospital Keyword: Vertebral artery , Proximal clipping , Balloon occlusion , Fusiform aneurysm , Dissecting aneurysm pp.325-332
Published Date 1992/4/10
DOI https://doi.org/10.11477/mf.1436900426
  • Abstract
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Seven cases of unclippable vertebral artery aneurysms (3 dissecting, 1 fusiform, 2 saccular and 1 giant) are reported. Five of these had subarachnoid hemorrhage, one showed mass effect and the other was found incidentally.

Trapping of the involved portion of the vertebral artery was performed in 4 cases, proximal clip occlu-sion in 2 and proximal balloon occlusion in 1. There were no operative deaths and no rebleeding, but brain-stem ischemia developed in 4 cases, two being transient and two permanent. The ischemic complications were possibly due to; (a) hypoperfusion in the transient cases and (b) thromboenbolism, from the partially thrombosed giant aneurysm or thrombosis of the cul-de-sac vertebral artery, in the permanent ones. Preoperative temporary vertebral artery occlusion with an inflatable balloon or postoperative anticoagu-lant therapy should be considered in the management protocol.


Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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