Editorial

Cardiac standstill

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Even with modern endovascular techniques, very large or giant complex posterior circulation aneurysms represent formidable treatment challenges. In the present issue of the Journal of Neurosurgery, the group from the Barrow Neurological Institute5 presents their updated experience with 105 cardiac standstill procedures in 103 patients with very large or giant aneurysms. More than 90% of these procedures were performed for posterior circulation aneurysms.

While cardiocirculatory arrest provides a bloodless field, softens the aneurysm, and facilitates isolation of the neck and separation from critical perforators, this procedure adds incredible complexities, which relate mostly to the high level

Article Information

Please include this information when citing this paper: published online October 15, 2010; DOI: 10.3171/2010.7.JNS091578.

© AANS, except where prohibited by US copyright law.

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References

1

Fiorella DKelly MEAlbuquerque FCNelson PK: Curative reconstruction of a giant midbasilar trunk aneurysm with the pipeline embolization device. Neurosurgery 64:2122172009

2

Heppner PAEllegala DBRobertson NNemergut EJaganathan JMee E: Basilar tip aneurysm—adenosine induced asystole for the treatment of a basilar tip aneurysm following failure of temporary clipping. Acta Neurochir (Wien) 149:5175202007

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Krisht AFKrayenbühl NSercl DBikmaz KKadri PA: Results of microsurgical clipping of 50 high complexity basilar apex aneurysms. Neurosurgery 60:2422502007

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Lawton MTRaudzens PAZabramski JMSpetzler RF: Hypothermic circulatory arrest in neurovascular surgery: evolving indications and predictors of patient outcome. Neurosurgery 43:10201998

5

Ponce FASpetzler RFHan PPWait SDKillory BDNakaji P: Cardiac standstill for cerebral aneurysms in 103 patients: an update on the experience at the Barrow Neurological Institute. Clinical article. J Neurosurg Published online October 15 2010; DOI: 10.3171/2010.9.JNS091178

6

Steinberg GKDrake CGPeerless SJ: Deliberate basilar or vertebral artery occlusion in the treatment of intracranial aneurysms. Immediate results and long-term outcome in 201 patients. J Neurosurg 79:1611731993

7

van Rooij WJSluzewski M: Endovascular treatment of large and giant aneurysms. AJNR Am J Neuroradiol 30:12182009

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