Temporary Clipping for Unruptured Aneurysms

Abstract

The stakes are often higher when operating on unruptured aneurysms compared with ruptured aneurysms because the patients are usually neurologically normal or minimally symptomatic. These are either incidental aneurysms discovered during screening for other symptoms or additional aneurysms in patients with subarachnoid hemorrhage. Unruptured aneurysms are being discovered and treated at an increasing rate, primarily as a result of the availability and improved quality of diagnostic imaging as well as a better understanding of the natural history. When operating on these aneurysms, the neurosurgeon generally has had adequate time to consider every possible scenario and plan ahead with the anesthesia team. Depending on the size, location, and morphology of the aneurysm and the surrounding vasculature, the neurosurgeon has the option of using temporary artery occlusion (TAO) or one of the cardiac standstill methods to facilitate dissection.