care of patients with aneurysmskjnojjnkjjjipjkpinojlm.mnjm

1. ANEURYSMS Perioperative nursing team

2. ANEURYSM
An aneurysm is an outward bulging, likened to a bubble or balloon, caused
by a localized, abnormal, weak spot on a blood vessel wall.
An aneurysm as seen in DSA

3. BASIC TYPES OF ANEURYSMD
BASED ON LOCATION
• PCOM (Posterior Communicating artery) Aneurysm
•ACOM ( Anterior Communicating artery) Aneurysm
•MCA (Middle cerebral artery) Aneurysm

5. EXTRA THINGS REQUIRED
• 1mm dissector
•Small tumour holding
•Aneurysm scissors
•Micro-byonet
•Insulin syringes
•Inj.papaverine in 5ml syringe (vasodilator- prevents vasoconstriction of
vessels that happens due to surgical manipulation)
•Small cottonoids
•Aneurysm tray ( has fine suction tips, mini and standard clip applicator,
mini and standard temporary and permanent clips)
•ICG (Indo Cyanine Green/ Aurogreen)

6. 2 TYPES OF APPLICATORS:-
1. STANDARD ( IN SIMPLE WORDS -BIGGER ONE)
2. MINI (IN SIMPLE WORDS- SMALLER ONE)

7. CLIPS USED IN NIMHANS
•Aesculap Yasargil aneurysm clips are
•non-ferromagnetic
• MRI-Safe (3-Tesla or less) implants
•crafted from Titanium

8. Silver coloued clips are the permanent
clips
Golden colored clips are the temporary
clips

9. 1.Standard straight
clip
2. Standard curved
clip
3. Standard forward angle
clip
4. Standard Fenestrated
clip
6. Standard fenestrated
forward angle clip
5. Standard fenestrated
right angled clip

10. CARE OF ANEURYSM APPLICATOR
•First of all differentiate between standard(for standard temporary and
permanent clips) and mini (for mini temporary and permanent
clips)applicator.
•Gently handle the applicator while loading and unloading the clip as
the instrument is very delicate.
•If any defect or malfunction is found in the applicators, report it
immediately to the superiors
•After the dural closure, send the aneurysm applicators, suction tips
and clips separately.

11. BASIC PROCEDURE
oPositioning
oCraniotomy(usually Pterional) and basal drilling
oDural opening
oDissection of aneurysm
oApplication of temporary clip to the parent artery
oChecking for any rupture using dissector
oApplication of permanent clip
oAgain checking for any rupture using dissector
oPlacing gelfoam soaked in Inj. Papavarin ( size - )
oIcg for confirmation
oClosure

12. CLIPPING OF ACOM ANEURYSM
Video Link:-
https://www.youtube.com/watch?v=myOHFz5s07o

13. THANK YOU