Booster clips for giant and thick-based aneurysms

T. M. Sundt, D. G. Piepgras, W. R. Marsh

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The authors describe their experience using booster clips to secure the closure of primary clips in the repair of giant and other thick-walled aneurysms. These clips were used for 21 aneurysms in 20 patients, comprising 12% of all aneurysms operated on during the 15-month period of the report, but representing about 50% of all giant aneurysms operated on during the same time frame. These clips are designed to encircle the primary clip and have fixation 'shoes' to close upon the jaws of the primary clip. All aneurysms were opened for decompression and thrombectomy when necessary following temporary major vessel occlusion before placement of the primary clip. Cerebral blood flow measurements and continuous electroencephalographic monitoring were utilized to predict the brain's tolerance to temporary ligation of the internal carotid artery (ICA) in those cases with a giant aneurysm arising from that vessel. There were no complications attributable to the periods of intracranial or cervical ICA occlusion; these periods varied but did not exceed 8 minutes for the former nor the tolerance period for the latter, which was calculated as from 5 to 30 minutes. It was necessary to reoperate on two patients and reposition clips because of stenoses or occlusions identified on immediate postoperative angiography. Fifteen patients had normal neurological function at the time of discharge. Three patients had minor deficits which did not prevent employment; two of these were related to a preoperative deficit and one was a complication of delayed ischemia. There were two deaths: one from bleeding complications and probable damage to perforating vessels in a patient operated on under profound hypothermia (the only case in the series so managed), and one from respiratory complications in a patient with severe pulmonary problems.

Original languageEnglish (US)
Pages (from-to)751-762
Number of pages12
JournalJournal of Neurosurgery
Volume60
Issue number4
StatePublished - 1984

Fingerprint

Surgical Instruments
Aneurysm
Internal Carotid Artery
Cerebrovascular Circulation
Thrombectomy
Shoes
Decompression
Jaw
Hypothermia
Ligation
Angiography
Pathologic Constriction
Ischemia
Hemorrhage
Lung
Brain

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Sundt, T. M., Piepgras, D. G., & Marsh, W. R. (1984). Booster clips for giant and thick-based aneurysms. Journal of Neurosurgery, 60(4), 751-762.

Booster clips for giant and thick-based aneurysms. / Sundt, T. M.; Piepgras, D. G.; Marsh, W. R.

In: Journal of Neurosurgery, Vol. 60, No. 4, 1984, p. 751-762.

Research output: Contribution to journalArticle

Sundt, TM, Piepgras, DG & Marsh, WR 1984, 'Booster clips for giant and thick-based aneurysms', Journal of Neurosurgery, vol. 60, no. 4, pp. 751-762.
Sundt TM, Piepgras DG, Marsh WR. Booster clips for giant and thick-based aneurysms. Journal of Neurosurgery. 1984;60(4):751-762.
Sundt, T. M. ; Piepgras, D. G. ; Marsh, W. R. / Booster clips for giant and thick-based aneurysms. In: Journal of Neurosurgery. 1984 ; Vol. 60, No. 4. pp. 751-762.
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