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Thermal diffusion blood flow monitoring during aneurysm surgery

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Summary

Cortical blood flow (CoBF) monitoring with a thermal diffusion flow probe was performed during the clipping of aneurysms of the ICA and MCA regions, on a series of patients during the acute stage of subarachnoid haemorrhage. Emphasis was placed on the CoBF recovery after temporary clip release. Since the absolute value in this technique is unreliable, recovery of blood flow after temporary clipping is represented as %CoBF according to the following equation: %CoBF recovery = (CoBFpost-CoBFintra)/(CoBFpre-CoBFintra)

Presumably, this parameter checks the patency of the concerned cerebral vessels during clipping and/or release. Percent recovery of more than 100%, indicating postischaemic reactive hyperaemia, was observed immediately after release of the temporary clips in 8 of the 9 cases evaluated. In one case, with prolonged temporary clipping (37 min), no immediate recovery was observed after clip release, suggesting no-reflow phenomenon. The value slowly recovered after local administration of papaverin and returned to the pre-occlusion level within 20 minutes.

Thermal diffusion CoBF monitoring may be useful in detecting the possible no-reflow phenomenon, that may lead to ischaemic complication, even after successful aneurysm clipping.

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital of Zürich, Switzerland

    N. Ogata, J. -Y. Fournier, H. -G. Imhof & Y. Yonekawa

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  1. N. Ogata
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  2. J. -Y. Fournier
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  3. H. -G. Imhof
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  4. Y. Yonekawa
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Ogata, N., Fournier, J.Y., Imhof, H.G. et al. Thermal diffusion blood flow monitoring during aneurysm surgery. Acta neurochir 138, 726–731 (1996). https://doi.org/10.1007/BF01411479

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