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The current technical possibilities of the peroperative safety advancement in the microsurgery of cerebral aneurysms – a review article


Authors: V. Přibáň 1;  I. Holečková 1;  J. Mraček 1;  D. Štěpánek 1;  J. Fiedler 2
Authors‘ workplace: Neurochirurgické oddělení, Lékařská fakulta v Plzni, Univerzita Karlova v Praze a Fakultní nemocnice Plzeň, primář: MUDr. V. Přibáň, Ph. D. 1;  Neurochirurgické oddělení, Nemocnice České Budějovice a. s, primář MUDr. V. Chlouba 2
Published in: Rozhl. Chir., 2013, roč. 92, č. 9, s. 481-487.
Category: Review

Overview

The authors present the technical aspects of perioperative safety during the microsurgery of cerebral aneurysms. We evaluated the advantages and disadvantages of the microvascular Doppler ultrasonography, the intraoperative digital subtraction angiography, the intraoperative transit time flowmetry, the intraoperative monitoring - motor evoked potentials and somatosensory evoked potentials, and the ICG videoangiography. The authors, based on their own experience, recommend combining different methods to eliminate the weak points of the individual specific methods. Combining the ICG with the flowmetry and the motor evoked potentials enhances safety during the surgery of cerebral aneurysms with the resultant reduction of the perioperative morbidity/mortality.

Key words:
cerebral aneurysm – ICG videoangiography – intraoperative DSA – motor evoked potentials MEP – mirovascular Doppler ultrasonography MDU – intraoperative flowmetry TTFM


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