医学
剪裁(形态学)
剪辑
动脉瘤
外科
闭塞
放射科
语言学
哲学
作者
Narayanam Anantha Sai Kiran,Behnam Rezai Jahromi,Joham Choque‐Velasquez,Ferzat Hijazy,Felix Goehre,Riku Kivisaari,Chaiyot Siangprasertkij,Luis Francisco Munoz Gallegos,Hanna Lehto,Juha Hernesniemi
出处
期刊:Operative Neurosurgery
[Oxford University Press]
日期:2014-09-24
卷期号:11 (1): 3-7
被引量:13
标识
DOI:10.1227/neu.0000000000000557
摘要
The treatment of very small (≤ 3 mm) aneurysms is technically challenging. Mini-clips used for clipping these small aneurysms have a smaller closing force compared with standard clips.To describe the double-clip technique for very small aneurysms.The double-clip technique, a parallel duplication clipping technique of booster clipping, is used by the senior author for clipping very small aneurysms with morphology suitable for the application of 2 clips. The aneurysm is clipped after application of temporary clip(s), administration of adenosine, or both. An initial mini-clip is applied, leaving a small residual neck sufficient for application of the second mini-clip. A second mini-clip of the same size and shape is applied on the residual neck parallel to the initial clip. The initially applied mini-clip, which is in close contact with the second clip, supports the second clip and prevents its slippage. This technique was retrospectively reviewed over a 13-year period (1997-2009). There were 3246 patients with 4757 aneurysms treated in the same period.The outcomes of 39 patients with 40 very small aneurysms clipped with the double-clip technique were analyzed. None of the patients had technique-related complications. Postoperative angiograms revealed complete aneurysm occlusion of 39 aneurysms and a small residual neck in 1 aneurysm. No parent artery obstruction was observed in the postoperative angiogram.The double-clip technique is a safe and effective variation of booster clipping in the treatment of very small aneurysms with suitable morphology.
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