Skip Navigation LinksHome > December 2010 - Volume 67 - Issue > A Novel Aneurysm Clip Design for Atheromatous, Thrombotic, o...
doi: 10.1227/NEU.0b013e3181f7451b

A Novel Aneurysm Clip Design for Atheromatous, Thrombotic, or Previously Coiled Lesions: Preliminary Experience With the “Compression Clip” in 6 Cases

Nussbaum, Eric S MD1; Nussbaum, Leslie A MD, PhD1

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BACKGROUND: Large and giant lesions often have thicker, atheromatous walls as well as intra-aneurysmal thrombus that combine to prevent traditional clips from closing properly in some cases.

OBJECTIVE: To report the development and use of a novel clip design specifically tailored to treat atheromatous, thrombotic, or previously coiled aneurysms.

METHODS: We retrospectively reviewed the records of 6 patients with complex aneurysms not amenable to simple neck clipping and not considered appropriate for endovascular therapy who were treated using a novel “compression” clip design. We describe the development and use of a novel aneurysm clip design with blades that are not opposed at rest to allow direct clipping of atheromatous, thrombotic, and previously coiled aneurysms.

RESULTS: Four patients had recurrent, previously coiled aneurysms; one of these also had a large thrombotic component. Two patients had complex lesions with heavy atheroma involving a portion of their aneurysms. There were no complications related to the use of the clip, and all patients did well without neurological complications. In every case, the clip allowed straightforward obliteration of the aneurysm without the need for temporary vascular occlusion, aneurysmorrhaphy, or removal of an intra-aneurysmal coil mass. All patients underwent intraoperative angiography to confirm obliteration of the aneurysm with preservation of the normal vasculature.

CONCLUSION: Atheromatous, thrombotic, and previously coiled aneurysms may not be treatable with simple neck clipping and may not be curable with endovascular therapy. For such cases, we designed a novel “compression” clip that has been used safely and successfully in our experience with good short-term follow-up.

Copyright © by the Congress of Neurological Surgeons


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