Measures of retrograde uction decompression during giant paraclinoidal internal carotid artery neurysms

Abstract

Objective To explore the nursing operation measures for the special method of retrograde uction decompression during giant paraclinoidal neurysms. Methods 12 cases of giant paraclinoidal aneurysms were selected, and the size of aneurysm ranged from 2 to 4.2 cm. Pterional approach was used in all cases. After temporary trapping, a No. 16 angiocatheter was inserted into the cervical internal carotid artery. The end portion of catheter was then connected to an autologous blood reuse unit through a negative pressure drainage, allowing the aneurysm rapid deflation without the cutting of aneurysm. Results The aneurysms significantly deflated after the retrograde suction and were clipped safely and satisfactorily in 8 cases. Preoperational prepartion was adequate, and intra-operational cooperation was quick and skilled. Aneurysm deflation was not clear in 4 cases after retrograde suction, wherein aneurysm was clipped in 3 cases after intra-tumor thrombus was removed when cutting the aneurysm, and aneurysm isolation in combination with bridging between external carotid artery-middle cerebral artery by saphenous vein grafts was conducted in 1 case. Postoperative angiography was taken in 8 cases, showed that aneurysms was clipped satisfactorily. The scores of GOS were good in 10 caese and poor in 1 case. There was 1 case of death. Conclusions Retrograde suction decompression can make most of paraclinoidal aneurysms deflation. Adequate prepartion before operation and skilled cooperation during operation can shorten the times of brain hypoxia-ischemia after blocking the cerebral aneurysm during operation. The pateints acquire satisfactional nursing effect during operation. Key words: Intra-operational nursing; Paraclinoidal aneurysm; Retrograde suction; Decompression of aneurysm