Temporary clippingの有用性と問題点

抄録

Temporary clipping has demerits; for example, arterial injury or circulatory disturbance. It has been believed that temporary clipping should not be indicated because of these demerits. Recently, with the advancement of operating techniques, balloon method and monitoring, temporary stopping of cerebral arterial circulation can be done safely. We have used temporary clipping in 52 (16.3%) out of 320 cases of aneurysms.
The reason for temporary clipping was A: premature rupture (9), B: removal of a giant aneurysm (5), C: bypass formation (5), D: correction of incomplete clipping (12), E: reduction of multiple clipping (9), and F: manipulation of invisible or hiddened tissue (12). Duration of temporary clipping was 3-45 minutes average of 7 minutes. Cause A. B. C. were longer than D. E. F.. The number of clip was 2-4 and more in the cause A. B. C. than D. E. F.. The comment for temporary clip were 1. in the case of sclerotic artery or vasospasm, temporary clipping was contraindication. 2. many temporary clips disturbed watching the operation field and manipulation. 3. Temporary clipping should be indicated before premature rupture because uncontrollable point sucking cases led farther aneurysmal rupture or tissue damage and sometimes led to impossible state of clipping.