İntrakraniyal anevrizma cerrahisi sırasında kan akımının geçici olarak durdurulması yöntemleri

Year 2024, Volume: 33 Issue: 2, 77 - 85, 30.06.2024

Yasemin Güneş , Demet Laflı Tunay

https://doi.org/10.17827/aktd.1451398

Abstract

Yüksek morbidite ve mortalite oranına sahip serebral anevrizmaların tek etkili tedavisi endovasküler veya cerrahi onarımdır. Bu girişimler, anevrizmaya sekonder subaraknoid kanamayı (SAK) tedavi etmede, daha fazla morbiditeyi engellemede ve aynı zamanda henüz rüptüre olmamış anevrizmalarda SAK’ı önlemede kullanılır. Serebral anevrizmaların, mikrocerrahi teknik ile anevrizmanın boynuna bir klip yerleştirilerek uygulanan cerrahi tedavisi etkili ve güvenli prosedürler olmakla birlikte belirli zorlukları da içerir. Özellikle de büyük yapılı, kritik serebral ve vasküler yapılara yakın ve derin yerleşimli anevrizmalarda klipaj aşaması oldukça kritiktir. Cerrahi anevrizma tedavisiyle ilişkili riskler arasında beyin retraksiyonu, geçici arteriyel tıkanıklık ve intraoperatif kanamanın neden olduğu yeni veya kötüleşen nörolojik defisitler yer alır. Bu riskleri azaltmak için, anevrizma boynunun klipajı aşamasında kan akımını geçici olarak durdurmada veya azaltmada kullanılan çeşitli yöntemler tanımlanmıştır. Bunlar arasında, hızlı ventriküler pacing (RVP), derin hipotermik kardiyak arrest (DHCA) ve adenozin kaynaklı hipotansiyon ve asistoli yer almaktadır.
Anahtar sözcükler: Adenozin-ilişkili kardiyak arrest, intrakraniyal anevrizma cerrahisi, geçici kalp durması, kan akımı

Keywords

Adenozin-ilişkili kardiyak arrest, intrakraniyal anevrizma cerrahisi, geçici kalp durması, kan akımı

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