Management of aneurysmal rupture during surgery, using bipolar coagulation, deep hypotension, and the operating microscope

The rupture of a saccular aneurysm during a direct attack can led to a disastrous result unless deep hypotension has been induced before the dissection. If the mean pressure recorded through a microcatheter introduced into the radial artery is at 30 mm Hg level or below the rupture remains circumscribed and the operative field can be dried easily with adjustable suction wherever the situation of the rupture may be. This technique was used in 52 cases with the operative microscope which enables, a clear vision of the lesion and of its vicinity. The mortality was 2, or 3.8%, in spite of 34 operative ruptures.