Papers

International journal
Feb 26, 2020

Precise MEP monitoring with a reduced interval is safe and useful for detecting permissive duration for temporary clipping.

Scientific reports
  • Masahiro Kameda
  • ,
  • Tomohito Hishikawa
  • ,
  • Masafumi Hiramatsu
  • ,
  • Takao Yasuhara
  • ,
  • Kazuhiko Kurozumi
  • ,
  • Isao Date

Volume
10
Number
1
First page
3507
Last page
3507
Language
English
Publishing type
Research paper (scientific journal)
DOI
10.1038/s41598-020-60377-9

Although temporary clipping of the parent artery is an indispensable technique in clipping surgery for intracranial aneurysms, the permissive duration of temporary clipping is still not well known. The aim of this study is to confirm the safety of precise motor evoked potential (MEP) monitoring and to estimate the permissive duration of temporary clipping for middle cerebral artery (MCA) aneurysm based on precise MEP monitoring results. Under precise MEP monitoring via direct cortical stimulation every 30 seconds to 1 minute, surgeons released a temporary clip and waited for MEP amplitude to recover following severe (>50%) reduction of MEP amplitude during temporary clipping. Precise MEP monitoring was safely performed. Twenty-eight instances of temporary clipping were performed in 42 MCA aneurysm clipping surgeries. Because precise MEP monitoring could be used to determine when to release a temporary clip even with a severe reduction in MEP amplitude due to lengthy temporary clipping, no patients experienced permanent postoperative hemiparesis. Based on logistic regression analysis, if a temporary clip is applied for 312 seconds or more, there is a higher probability of a severe reduction in MEP amplitude. We should therefore release temporary clips after 5 minutes in order to avoid permanent postoperative hemiparesis.

Link information
DOI
https://doi.org/10.1038/s41598-020-60377-9
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32103082
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044220
ID information
  • DOI : 10.1038/s41598-020-60377-9
  • Pubmed ID : 32103082
  • Pubmed Central ID : PMC7044220

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