Aneurysm clips: What every resident should know

Sasidharan, Gopalakrishnan M; Sastri, Savitr B V; Pandey, Paritosh

doi:10.4103/0028-3886.152666

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…Thus, the closure forces vary widely between the intracranial aneurysm clips and vascular clips. The closure forces of intracranial aneurysm clips and vascular clips are usually set at around 70-180 g [21] and 15-30 g [22], respectively. The huge difference in the closure force between these two kinds of clips is one of the reasons causing the varied compression duration among studies [9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Characterizing the Impact of Compression Duration and Deformation-Related Loss of Closure Force on Clip-Induced Spinal Cord Injury in Rats

Lee,

Hsu,

Tien

et al. 2023

Neurology International

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The clip-induced spinal cord injury (SCI) rat model is pivotal in preclinical SCI research. However, the literature exhibits variability in compression duration and limited attention to clip deformation-related loss of closure force. We aimed to investigate the impact of compression duration on SCI severity and the influence of clip deformation on closure force. Rats received T10-level clip-induced SCI with durations of 1, 5, 10, 20, and 30 s, and a separate group underwent T10 transection. Outcomes included functional, histological, electrophysiological assessments, and inflammatory cytokine analysis. A tactile pressure mapping system quantified clip closure force after open–close cycles. Our results showed a positive correlation between compression duration and the severity of functional, histological, and electrophysiological deficits. Remarkably, even a brief 1-s compression caused significant deficits comparable to moderate-to-severe SCI. SSEP waveforms were abolished with durations over 20 s. Decreased clip closure force appeared after five open–close cycles. This study offers critical insights into regulating SCI severity in rat models, aiding researchers. Understanding compression duration and clip fatigue is essential for experiment design and interpretation using the clip-induced SCI model.

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Section: Discussionmentioning

confidence: 99%

Characterizing the Impact of Compression Duration and Deformation-Related Loss of Closure Force on Clip-Induced Spinal Cord Injury in Rats

Lee,

Hsu,

Tien

et al. 2023

Neurology International

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“…Fenestrated clips allow the surgeon an opportunity to repair the rupture site in the blades of the clip, by going around the parent vessel and engaging the vessel wall at the site of dehiscence (Figure 4). 22 away from arterial divisions, BBAs near bifurcations pose an additional challenge for more conventional reconstructive techniques. Placement of an encircling clip would be difficult without occluding either branch origins and clip-wrapping necessitates precise fashioning of slits to accommodate the branching artery.…”

Section: Discussionmentioning

confidence: 99%

Microsurgical Clip Reconstruction of a Ruptured Internal Carotid Artery Terminus Blister Aneurysm Using a Reverse Picket Fence Technique

Glauser

Detchou

Choudhri

2021

ONSURG

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BACKGROUND Blister aneurysms are rare, technically challenging lesions that are typically ill defined and arise at nonbranch points of arteries. OBJECTIVE To describe the microsurgical treatment of a ruptured blister aneurysm at the internal carotid artery (ICA) terminus using the reverse picket fence clipping technique. METHODS The patient was a 60-yr-old male. He presented with a Hunt and Hess Grade 2, Fisher Grade 3 subarachnoid hemorrhage located in the bilateral sylvian fissures (right > left) and suprasellar cisterns. Computed tomography angiography demonstrated 2 aneurysms: a 2-mm right middle cerebral artery (MCA) aneurysm and a 2.5-mm right internal carotid artery (ICA) terminus blister aneurysm. Transradial cerebral angiography was undertaken which showed these similar sized aneurysms. Microsurgical treatment was chosen, and the patient underwent a right pterional craniotomy for clipping of his aneurysms. The patient consented to the procedure. RESULTS The combination of stacked fenestrated clips repaired the vessel, with intraoperative fluorescein and indocyanine green angiography demonstrated normal filling of the MCA and ICA circulation with no delay. Intraoperative angiography confirmed induced moderate stenosis of the ICA terminus at about 50%, which is essential to close the blister aneurysm site by utilizing a portion of the normal vessel wall. CONCLUSION Ruptured blister aneurysms at the ICA terminus can be safely repaired using the reverse picket fence technique for clipping.

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