Clip Reinforcement Technique by Circumferential Wrapping with Silastic Sheet for Treatment of Cerebral Aneurysms and Its Follow-Up Outcome.
- Author:
Seung Ryeol SHIN
1
;
Tae Sun KIM
;
Je Hyuk LEE
;
Sung Pil JOO
;
In Young KIM
;
Shin JUNG
;
Jung Kil LEE
;
Jae Hyoo KIM
;
Soo Han KIM
;
Sam Suk KANG
Author Information
1. Department of Neurosurgery, School of Medicine, Chonnam National University, GwangJu, Korea. taesun@cnuh.com
- Publication Type:Original Article
- Keywords:
Aneurysm;
Silastic sheet;
Clip reinforcement;
Wrapping
- MeSH:
Aneurysm;
Arteries;
Carotid Artery, Internal;
Constriction, Pathologic;
Follow-Up Studies*;
Hematoma;
Humans;
Intracranial Aneurysm*;
Parents
- From:Korean Journal of Cerebrovascular Surgery
2004;6(1):38-44
- CountryRepublic of Korea
- Language:Korean
-
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.
