Clipping techniques in cerebral aneurysm surgery. 2016

Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
Department of Neurosurgery, IRCCS, Bellaria Hospital, Bologna, Italy - nicola.acciarri@ausl.bologna.it.

The history of cerebral aneurysm surgery owes a great tribute to the tenacity of pioneering neurosurgeons who designed and developed the clips used to close the aneurysms neck. However, until the beginning of the past century, surgery of complex and challenging aneurysms was impossible due to the lack of surgical microscope and commercially available sophisticated clips. The modern era of the spring clips began in the second half of last century. Until then, only malleable metal clips and other non-metallic materials were available for intracranial aneurysms. Indeed, the earliest clips were hazardous and difficult to handle. Several neurosurgeons put their effort in developing new clip models, based on their personal experience in the treatment of cerebral aneurysms. Finally, the introduction of the surgical microscope, together with the availability of more sophisticated clips, has allowed the treatment of complex and challenging aneurysms. However, today none of the new instruments or tools for surgical therapy of aneurysms could be used safely and effectively without keeping in mind the lessons on innovative surgical techniques provided by great neurovascular surgeons. Thanks to their legacy, we can now treat many types of aneurysms that had always been considered inoperable. In this article, we review the basic principles of surgical clipping and illustrate some more advanced techniques to be used for complex aneurysms.

UI MeSH Term Description Entries
D008866 Microsurgery The performance of surgical procedures with the aid of a microscope.
D002532 Intracranial Aneurysm Abnormal outpouching in the wall of intracranial blood vessels. Most common are the saccular (berry) aneurysms located at branch points in CIRCLE OF WILLIS at the base of the brain. Vessel rupture results in SUBARACHNOID HEMORRHAGE or INTRACRANIAL HEMORRHAGES. Giant aneurysms (>2.5 cm in diameter) may compress adjacent structures, including the OCULOMOTOR NERVE. (From Adams et al., Principles of Neurology, 6th ed, p841) Aneurysm, Cerebral,Aneurysm, Intracranial,Basilar Artery Aneurysm,Berry Aneurysm,Brain Aneurysm,Cerebral Aneurysm,Giant Intracranial Aneurysm,Mycotic Aneurysm, Intracranial,Aneurysm, Anterior Cerebral Artery,Aneurysm, Anterior Communicating Artery,Aneurysm, Basilar Artery,Aneurysm, Middle Cerebral Artery,Aneurysm, Posterior Cerebral Artery,Aneurysm, Posterior Communicating Artery,Anterior Cerebral Artery Aneurysm,Anterior Communicating Artery Aneurysm,Middle Cerebral Artery Aneurysm,Posterior Cerebral Artery Aneurysm,Posterior Communicating Artery Aneurysm,Aneurysm, Berry,Aneurysm, Brain,Aneurysm, Giant Intracranial,Aneurysm, Intracranial Mycotic,Aneurysms, Basilar Artery,Aneurysms, Berry,Aneurysms, Brain,Aneurysms, Cerebral,Aneurysms, Giant Intracranial,Aneurysms, Intracranial,Aneurysms, Intracranial Mycotic,Artery Aneurysm, Basilar,Artery Aneurysms, Basilar,Basilar Artery Aneurysms,Berry Aneurysms,Brain Aneurysms,Cerebral Aneurysms,Giant Intracranial Aneurysms,Intracranial Aneurysm, Giant,Intracranial Aneurysms,Intracranial Aneurysms, Giant,Intracranial Mycotic Aneurysm,Intracranial Mycotic Aneurysms,Mycotic Aneurysms, Intracranial
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013525 Surgical Instruments Hand-held tools or implements used by health professionals for the performance of surgical tasks. Clamps, Surgical,Clips, Surgical,Clips, Tantalum,Forceps,Hooks, Surgical,Plugs, Surgical,Scissors, Surgical,Speculum,Surgical Clamps,Surgical Clips,Surgical Hooks,Surgical Plugs,Surgical Scissors,Surgical Valves,Trocar,Valves, Surgical,Clamp, Surgical,Clip, Surgical,Clips,Hook, Surgical,Instrument, Surgical,Plug, Surgical,Surgical Clamp,Surgical Clip,Surgical Hook,Surgical Plug,Surgical Valve,Valve, Surgical,Clip,Clip, Tantalum,Forcep,Instruments, Surgical,Speculums,Surgical Instrument,Tantalum Clip,Tantalum Clips,Trocars
D014656 Vascular Surgical Procedures Operative procedures for the treatment of vascular disorders. Vascular Surgery,Procedure, Vascular Surgical,Procedures, Vascular Surgical,Surgical Procedure, Vascular,Surgical Procedures, Vascular,Vascular Surgical Procedure,Surgeries, Vascular,Surgery, Vascular,Vascular Surgeries
D049673 History, 20th Century Time period from 1901 through 2000 of the common era. 20th Century History,20th Cent. History (Medicine),20th Cent. History of Medicine,20th Cent. Medicine,Historical Events, 20th Century,History of Medicine, 20th Cent.,History, Twentieth Century,Medical History, 20th Cent.,Medicine, 20th Cent.,20th Cent. Histories (Medicine),20th Century Histories,Cent. Histories, 20th (Medicine),Cent. History, 20th (Medicine),Century Histories, 20th,Century Histories, Twentieth,Century History, 20th,Century History, Twentieth,Histories, 20th Cent. (Medicine),Histories, 20th Century,Histories, Twentieth Century,History, 20th Cent. (Medicine),Twentieth Century Histories,Twentieth Century History
D049674 History, 21st Century Time period from 2001 through 2100 of the common era. 21st Century History,21st Cent. History (Medicine),21st Cent. History of Medicine,21st Cent. Medicine,Historical Events, 21st Century,History of Medicine, 21st Cent.,History, Twenty-first Century,Medical History, 21st Cent.,Medicine, 21st Cent.,21st Cent. Histories (Medicine),21st Cent. Medicines,21st Century Histories,Cent. Histories, 21st (Medicine),Cent. History, 21st (Medicine),Cent. Medicine, 21st,Cent. Medicines, 21st,Century Histories, 21st,Century Histories, Twenty-first,Century History, 21st,Century History, Twenty-first,Histories, 21st Cent. (Medicine),Histories, 21st Century,Histories, Twenty-first Century,History, 21st Cent. (Medicine),History, Twenty first Century,Medicines, 21st Cent.,Twenty-first Century Histories,Twenty-first Century History
D019635 Neurosurgical Procedures Surgery performed on the nervous system or its parts. Procedures, Neurosurgical,Surgical Procedures, Neurologic,Neurologic Surgical Procedure,Neurologic Surgical Procedures,Neurosurgical Procedure,Procedure, Neurologic Surgical,Procedure, Neurosurgical,Procedures, Neurologic Surgical,Surgical Procedure, Neurologic

Related Publications

Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
May 2008, No shinkei geka. Neurological surgery,
Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
January 1988, Acta neurochirurgica,
Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
August 2017, World neurosurgery,
Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
July 1994, Anaesthesia,
Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
February 2012, British journal of neurosurgery,
Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
October 2018, Journal of neurosurgery,
Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
December 2009, Masui. The Japanese journal of anesthesiology,
Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
September 2002, Neurosurgery,
Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
January 2016, Acta neurochirurgica. Supplement,
Nicola Acciarri, and Giovanni Toniato, and Andreas Raabe, and Giuseppe Lanzino
April 2016, World neurosurgery,
Copied contents to your clipboard!