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Cardiac standstill and circulatory flow arrest in surgical treatment of intracranial aneurysms: A historical review

机译：颅内动脉瘤外科治疗中的心脏停滞和循环流动骤运：历史评论

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摘要

Since the first surgery for an intracranial aneurysm in 1931, neurological surgeons have long strived to determine the optimal methods of surgical correction. Significant challenges of aneurysm clipping include intraoperative rupture and complex dome morphology. Hypothermia, cardiopulmonary bypass, pharmacologically induced hypotension, and cardiac standstill are a few of the methodologies historically and currently employed in the management of these issues. In the 1980s, significant advances in pharmacology and anesthesiology led to the use of agents such as adenosine for chemically induced hypotension and eventually complete circulatory arrest. Since the institution of the use of these agents, the traditional methods of circulatory arrest under conditions of hypothermia and cardiopulmonary bypass have fallen out of favor. However, there still exists a subset of technically difficult aneurysms for which cardiac standstill, both chemical and hypothermic, remains a viable therapeutic option. In this paper, the authors describe the history of cardiac standstill by both hypothermic and chemically induced means as well as provide examples in which these techniques are still necessary.
机译：自1931年对颅内动脉瘤的第一次手术以来，神经外科医生长期努力确定手术校正的最佳方法。动脉瘤夹具的重大挑战包括术中破裂和复杂的圆顶形态。体温过低，心肺旁路，药理学诱导的低血压和心脏停机是历史上的一些方法，目前在这些问题的管理中受雇。在20世纪80年代，药理学和麻醉学的显着进展导致使用腺苷等药剂用于化学诱导的低血压，最终完全完全循环停止。自用于使用这些药剂的机构以来，在体温过低和心肺旁路条件下，传统的循环停滞方法已经失控。然而，仍然存在技术上困难的动脉瘤的子集，该动脉瘤是一种心脏停滞，化学和低温仍然是可行的治疗选择。在本文中，作者描述了通过低温和化学诱导的手段的心脏停滞史以及提供这些技术仍然需要的实例。

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  • 来源
    《Neurosurgical focus》 |2014年第4期|共1页
  • 作者

    WrightJ.; HuangC.; SharmaR.; ManjilaS.; XuF.; DabbB.; BambakidisN.C.;

  • 作者单位

    Department of Neurological Surgery The Neurological Institute Cleveland OH United States;

    Department of Neurosurgery University of Southern California Scranton PN United States;

    The Commonwealth Medical College Scranton PN United States;

    Department of Neurological Surgery The Neurological Institute Cleveland OH United States;

    Department of Neurological Surgery The Neurological Institute Cleveland OH United States;

    Department of Anesthesiology University Hospitals Case Medical Center Cleveland OH United States;

    Department of Neurological Surgery The Neurological Institute Cleveland OH United States;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 外科学;
  • 关键词

    Aneurysm; Cardiac standstill; Circulatory arrest;

    机译：动脉瘤;心脏停滞;循环逮捕;

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