{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T19:43:26Z","timestamp":1769283806438,"version":"3.49.0"},"reference-count":51,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1988,2]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The operative management of large and giant aneurysms is complicated by their typically atheromatous and thick walls, frequent intramural thrombosis with calcification, and broad-based necks that often incorporate perforating and other vital vessels. Not infrequently, it is necessary to at least focally arrest the intracranial circulation and open or excise these aneurysms to facilitate vascular reconstruction. This maneuver, in patients whose disease processes have destroyed autoregulatory function or who have inadequate sources of anatomical collateral supply, may cause the threshold for permanent ischemic injury to be exceeded. The authors have recently treated 14 such patients while under electroencephalographic monitoring to document electrical burst suppression induced by the administration of etomidate, followed by temporary clipping to permit vascular repair and intraoperative angiography to document patency of parent arteries. Up to 60 minutes of internal carotid artery occlusion, 35 minutes of middle cerebral artery occlusion, 19 minutes of upper basilar artery occlusion, and 4\u00bd minutes of lower basilar artery occlusion have been well tolerated using this protocol. In such situations, etomidate may be effective in protecting the cerebral circulation without the detrimental cardiotoxicity observed with protective doses of barbiturates.<\/jats:p>","DOI":"10.3171\/jns.1988.68.2.0234","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:10:11Z","timestamp":1241799011000},"page":"234-240","source":"Crossref","is-referenced-by-count":167,"title":["Use of etomidate, temporary arterial occlusion, and intraoperative angiography in surgical treatment of large and giant cerebral aneurysms"],"prefix":"10.3171","volume":"68","author":[{"given":"H. Hunt","family":"Batjer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan I.","family":"Frankfurt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip D.","family":"Purdy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirley S.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duke S.","family":"Samson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","first-page":"242","volume":"94","author":"Baumgartner WA","year":"1983","journal-title":"Surgery"},{"key":"b2","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1001\/archneur.1967.00470300051009","volume":"17","author":"Cuatico W","year":"1967","journal-title":"Arch Neurol"},{"key":"b3","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1227\/00006123-198205000-00003","volume":"10","author":"Diaz FG","year":"1982","journal-title":"Neurosurgery"},{"key":"b4","first-page":"323","volume-title":"Monitoring in Anesthesia and Critical Care Medicine.","author":"Donegan JH","year":"1985"},{"key":"b5","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/neurosurgery\/26.CN_suppl_1.12","volume":"26","author":"Drake CG","year":"1979","journal-title":"Clin Neurosurg"},{"key":"b6","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1213\/00000539-198610000-00002","volume":"65","author":"Ebrahim ZY","year":"1986","journal-title":"Anesth Analg"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1981.54.2.0275"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1980.52.1.0001"},{"key":"b9","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1213\/00000539-197707000-00003","volume":"56","author":"Ghoneim MM","year":"1977","journal-title":"Anesth Analg"},{"key":"b10","first-page":"138","volume":"161","author":"Goldstein A","year":"1966","journal-title":"Arch Int Pharmacodyn Ther"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1016\/0090-3019(84)90405-1"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1984.61.2.0387"},{"key":"b13","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1227\/00006123-198302000-00004","volume":"12","author":"Heros RC","year":"1983","journal-title":"Neurosurgery"},{"key":"b14","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1227\/00006123-197907010-00004","volume":"5","author":"Hopkins LN","year":"1979","journal-title":"Neurosurgery"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1979.51.6.0743"},{"key":"b16","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1973.39.4.0503"},{"key":"b17","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1093\/bja\/57.5.509","volume":"57","author":"Kenyon CJ","year":"1985","journal-title":"Br J Anaesth"},{"key":"b18","first-page":"31","volume-title":"Anaesthesiology and Intensive Care Medicine 106.","author":"Kugler J","year":"1977"},{"key":"b19","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1227\/00006123-198502000-00009","volume":"16","author":"Matsuda M","year":"1985","journal-title":"Neurosurgery"},{"key":"b20","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1161\/01.STR.6.4.405","volume":"6","author":"Michenfelder JD","year":"1975","journal-title":"Stroke"},{"key":"b21","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1001\/archneur.1976.00500050031006","volume":"33","author":"Michenfelder JD","year":"1976","journal-title":"Arch Neurol"},{"key":"b22","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1097\/00000542-197311000-00010","volume":"39","author":"Michenfelder JD","year":"1973","journal-title":"Anesthesiology"},{"key":"b23","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/00000542-197010000-00013","volume":"33","author":"Michenfelder JD","year":"1970","journal-title":"Anesthesiology"},{"key":"b24","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1097\/00000542-198609001-00270","volume":"65","author":"Milde LN","year":"1986","journal-title":"Anesthesiology"},{"key":"b25","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1097\/00000542-198510000-00005","volume":"63","author":"Milde LN","year":"1985","journal-title":"Anesthesiology"},{"key":"b26","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/j.1365-2044.1985.tb10702.x","volume":"40","author":"Moore RA","year":"1985","journal-title":"Anaesthesia"},{"key":"b27","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1093\/neurosurgery\/16.CN_suppl_1.73","volume":"16","author":"Morley TP","year":"1969","journal-title":"Clin Neurosurg"},{"key":"b28","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1966.25.6.0660"},{"key":"b29","doi-asserted-by":"publisher","DOI":"10.1007\/BF01742677"},{"key":"b30","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1984.60.3.0560"},{"key":"b31","doi-asserted-by":"publisher","DOI":"10.1007\/BF01742676"},{"key":"b32","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1093\/bja\/50.10.1047","volume":"50","author":"Renou AM","year":"1978","journal-title":"Br J Anaesth"},{"key":"b33","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1227\/00006123-198407000-00025","volume":"15","author":"Robbins J","year":"1984","journal-title":"Neurosurgery"},{"key":"b34","first-page":"1414","volume-title":"Neurosurgery.","volume":"2","author":"Roski RA","year":"1985"},{"key":"b35","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-198205000-00010"},{"key":"b36","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1981.55.3.0337"},{"key":"b37","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1227\/00006123-198003000-00015","volume":"6","author":"Silverberg GD","year":"1980","journal-title":"Neurosurgery"},{"key":"b38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1161\/01.STR.5.1.1","volume":"5","author":"Smith AL","year":"1974","journal-title":"Stroke"},{"key":"b39","first-page":"81","volume":"8","author":"Sonntag VKH","year":"1977","journal-title":"Surg Neurol"},{"key":"b40","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1980.53.1.0022"},{"key":"b41","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1161\/01.STR.9.2.140","volume":"9","author":"Steen PA","year":"1978","journal-title":"Stroke"},{"key":"b42","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1984.60.1.0145"},{"key":"b43","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1981.54.3.0346"},{"key":"b44","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1982.57.2.0240"},{"key":"b45","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1979.51.6.0731"},{"key":"b46","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1984.60.4.0751"},{"key":"b47","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1984.61.6.1009"},{"key":"b48","first-page":"S53","volume":"2","author":"Wauquier A","year":"1982","journal-title":"J Cereb Blood Flow Metab"},{"key":"b49","first-page":"330","volume":"249","author":"Wauquier A","year":"1981","journal-title":"Arch Int Pharmacodyn Ther"},{"key":"b50","first-page":"181","volume-title":"Stroke. Advances in Neurology","volume":"16","author":"Ya\u015fargil MG","year":"1977"},{"key":"b51","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1161\/01.STR.3.6.726","volume":"3","author":"Yatsu FM","year":"1972","journal-title":"Stroke"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/68\/2\/article-p234.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/68\/2\/article-p234.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/68\/2\/article-p234.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T05:17:30Z","timestamp":1652505450000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/68\/2\/article-p234.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1988,2]]},"references-count":51,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/jns.1988.68.2.0234","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1988,2]]}}}