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Intraoperative Measurement of Arterial Blood Flow in Aneurysm Surgery

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Book cover Trends in the Management of Cerebrovascular Diseases

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 129))

Abstract

Intraoperative flowmetry (IF) has been recently introduced during cerebral aneurysm surgery in order to obtain a safer surgical exclusion of the aneurysm. This study evaluates the usefulness of IF during surgery for cerebral aneurysms and compares the results obtained in the joined surgical series of Verona and Padua to the more recent results obtained at the neurosurgical department of Verona.

In the first surgical series, between 2001 and 2010, a total of 312 patients were submitted to IF during surgery for cerebral aneurysm at the neurosurgical departments of Verona and Padua: 162 patients presented with subarachnoid hemorrhage (SAH) whereas 150 patients harbored unruptured aneurysms. In the second series, between 2011 and 2016, 112 patients were submitted to IF during surgery for cerebral aneurysm at the neurosurgical department of Verona; 24 patients were admitted for SAH, whereas 88 patients were operated on for unruptured aneurysms.

Comparison of the baseline values in the two surgical series and the baseline values between unruptured and ruptured aneurysms showed no statistical differences between the two clinical series. Analysis of flowmetry measurements showed three types of loco-regional flow derangements: hyperemia after temporary arterial occlusion, redistribution of flow in efferent vessels after clipping, and low flow in patients with SAH-related vasospasm.

IF provides real-time data about flow derangements caused by surgical clipping of cerebral aneurysm, thus enabling the surgeon to obtain a safer exclusion; furthermore, it permits the evaluation of other effects of clipping on the loco-regional blood flow. It is suggested that—in contribution with intraoperative neurophysiological monitoring—IF may now constitute the most reliable tool for increasing safety in aneurysm surgery.

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Author information

Authors and Affiliations

  1. Section of Vascular Neurosurgery, Institute of Neurosurgery, Verona City and University Hospital, Verona, Italy

    Alberto Pasqualin M.D.

  2. Institute of Neurosurgery, Verona City and University Hospital, Verona, Italy

    Pietro Meneghelli M.D., Angelo Musumeci M.D. & Giampietro Pinna M.D.

  3. Division of Neurosurgery, Padua City Hospital, Padova, Italy

    Alessandro Della Puppa M.D. & Renato Scienza M.D.

  4. Division of Neurosurgery, Baggiovara Hospital, Modena, Italy

    Giacomo Pavesi M.D.

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  1. Alberto Pasqualin M.D.
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  2. Pietro Meneghelli M.D.
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  4. Alessandro Della Puppa M.D.
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  5. Giacomo Pavesi M.D.
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  6. Giampietro Pinna M.D.
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  7. Renato Scienza M.D.
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Editor information

Editors and Affiliations

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

    Giuseppe Esposito

  2. Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Luca Regli

  3. Department of Neurosurgery, Asahi Uni Murakami Memorial Hospital, Gifu, Japan

    Yasuhiko Kaku

  4. Department of Neurosurgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan

    Tetsuya Tsukahara

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Pasqualin, A. et al. (2018). Intraoperative Measurement of Arterial Blood Flow in Aneurysm Surgery. In: Esposito, G., Regli, L., Kaku, Y., Tsukahara, T. (eds) Trends in the Management of Cerebrovascular Diseases. Acta Neurochirurgica Supplement, vol 129. Springer, Cham. https://doi.org/10.1007/978-3-319-73739-3_7

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  • DOI: https://doi.org/10.1007/978-3-319-73739-3_7

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