Profound hypothermia and circulatory arrest with skull base approaches for treatment of complex posterior circulation aneurysms

Acta Neurochir (Wien). 1999;141(1):1-11; discussion 11-2. doi: 10.1007/s007010050259.


Objective: Cardiopulmonary bypass with profound hypothermia and circulatory arrest has seen a resurgence as an adjunct technique in neurological surgery. We report our experience with this technique in treating seven complex vertebro-basilar aneurysms.

Methods: Skull base approaches were used in all cases, providing excellent exposure and minimizing brain retraction. There were six basilar artery aneurysms and one giant fusiform vertebro-basilar artery aneurysm. All aneurysms but one had an apparent neck, which could be clipped. The fusiform vertebro-basilar artery aneurysm was trapped, partially resected, and the circulation was reestablished with a saphenous vein graft from the cervical internal carotid artery to the mid-basilar artery.

Results: Five patients had an excellent outcome and two had a good outcome at one year or at latest follow up. Two of the patients showed improvement of neurological deficits which were present before the surgical intervention.

Conclusion: Applying very strict selection criteria in this small series of patients with posterior circulation aneurysms, excellent or good results were achieved using the profound hypothermic circulatory arrest technique.

Publication types

  • Case Reports
  • Clinical Trial

MeSH terms

  • Adolescent
  • Aged
  • Antifibrinolytic Agents / therapeutic use
  • Cardiopulmonary Bypass / methods*
  • Cerebral Revascularization / methods
  • Cerebral Revascularization / standards
  • Female
  • Follow-Up Studies
  • Heart Arrest, Induced / methods*
  • Hemostatic Techniques
  • Humans
  • Hypothermia, Induced / methods*
  • Intracranial Aneurysm / classification
  • Intracranial Aneurysm / pathology
  • Intracranial Aneurysm / surgery*
  • Intraoperative Complications / prevention & control
  • Male
  • Middle Aged
  • Patient Selection
  • Skull Base / surgery
  • Treatment Outcome


  • Antifibrinolytic Agents