Abstract
In principle, surgery of aneurysms must be done without bleeding, so that an approach should be selected that does not touch the ruptured site of the aneurysm. This paper will report how to control and treat bleeding if it occurs during operation.
(1) Thought must be give to how and where to control bleeding if it occurs during the approach.
(2) If ruptures, it is very important to suck the blood so that the bleeding point of the aneurysm can be observed.
(3) Temporary clipping, tentative clipping and dome coagulation methods are useful.
(4) When a broad necked aneurysm ruptures at the neck, it is difficult to control the bleeding with ordinary clips because ruptured site belongs to the rest of the aneurysm. The fenestrated clip is useful for controlling such bleeding.
(5) When the aneurysm is torn away, it is sometimes possible to reconstruct the parent arteries by suturing or by coagulation of the aneurysmal orifice.
These technical points are described.
