Korean J Cerebrovasc Surg.  2004 Mar;6(1):38-44.

Clip Reinforcement Technique by Circumferential Wrapping with Silastic Sheet for Treatment of Cerebral Aneurysms and Its Follow-Up Outcome

Affiliations
  • 1Department of Neurosurgery, School of Medicine, Chonnam National University, GwangJu, Korea. taesun@cnuh.com

Abstract


OBJECTIVE
To describe the clip reinforcement technique by circumferential wrapping with silastic sheet for the treatment of unclippable cerebral aneurysms and evaluate its long term follow-up results.
METHODS
The nature of 26 unclippable aneurysms were as follow:12 blister-like superior wall aneurysm of internal carotid artery (ICA), 6 microaneurysms (<2 mm), 4 fusiform aneurysms, 4 broad-based aneurysms. After aneurysm and the parent artery are circumferentially wrapped by silastic sheet, aneurysm clips are positioned on the sheet with parallel to the parent artery. The mean follow-up period was 37 months (range, 3-140 months).
RESULTS
25 of 26 patients had a favorable outcome and one patient had a severe disabled due to severe vasospasm at 3 months after operation. Of the 21 patients who underwent immediate angiographic examination, stenosis of parent artery was detected in 6 patients and remnant of aneurysm in 4 patients. Asymptomatic occlusion of parent artery was observed in one patient on follow-up angiographic examination. 22 of 24 patients followed-up for a long time had a favorable outcome and 2 patients had a severe disabled (one patient was due to previous severe disabled and the other was due to thalamic intracerebral hematoma developed during the follow-up period).
CONCLUSION
In our study, there was no clip reinforcement technique-related clinical complications such as rebleeding of aneurysm or ischemic event during follow-up period. Clip reinforcement technique by circumferential wrapping with silastic sheet is simple and useful method for the unclippable cerebral aneurysm.

Keyword

Aneurysm; Silastic sheet; Clip reinforcement; Wrapping

MeSH Terms

Aneurysm
Arteries
Carotid Artery, Internal
Constriction, Pathologic
Follow-Up Studies*
Hematoma
Humans
Intracranial Aneurysm*
Parents
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