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The efficiency of the new Yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm

BACKGROUND: The fenestrated clip is sometimes useful in limited approach angle and narrow working space. However, before the development of the new Yasargil titanium fenestrated mini-clip, the only variations of fenestrated clips were those of larger sizes. And those larger clips have a problem of t...

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Autores principales: Ota, Nakao, Tanikawa, Rokuya, Noda, Kosumo, Tsuboi, Toshiyuki, Kamiyama, Hiroyasu, Tokuda, Sadahisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653327/
https://www.ncbi.nlm.nih.gov/pubmed/26664871
http://dx.doi.org/10.4103/2152-7806.168072
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author Ota, Nakao
Tanikawa, Rokuya
Noda, Kosumo
Tsuboi, Toshiyuki
Kamiyama, Hiroyasu
Tokuda, Sadahisa
author_facet Ota, Nakao
Tanikawa, Rokuya
Noda, Kosumo
Tsuboi, Toshiyuki
Kamiyama, Hiroyasu
Tokuda, Sadahisa
author_sort Ota, Nakao
collection PubMed
description BACKGROUND: The fenestrated clip is sometimes useful in limited approach angle and narrow working space. However, before the development of the new Yasargil titanium fenestrated mini-clip, the only variations of fenestrated clips were those of larger sizes. And those larger clips have a problem of the triangle-shaped gap at the proximal end of the blade. The authors describe the efficiency, limitations and surgical technique of using the Yasargil titanium fenestrated mini-clip. METHODS: Fifty-nine cases of aneurysms were treated using these mini-clips. Aneurysm location, size and dome neck ratio, mean follow-up period, neck remnant, and recurrence rate were also analyzed. Among these cases, we present eight characteristic cases, including a case with aneurysm recurrence, and we review the problems associated with the triangle-shaped gap at the proximal end of the clip. RESULTS: The average size of the aneurysms was 5.57 mm, and the dome neck ratio was >2.0 in 1.69%, >1.5 in 11.8%, >1.2 in 35.6%, and <1.2 in 50.8% of cases. The mean follow-up period for the 59 cases was 5.5 months (range, 0.5–16 months). Angiographic recurrence of the treated portion occurred in 1 case (1.7%), including an aneurysm in the basilar artery tip aneurysm. CONCLUSION: The availability of the Yasargil titanium fenestrated mini-clip increases the options for clipping to minimize the remnant of the clipped aneurysm. However, there is still concern over the triangular space at the base of the blade, especially when treating an aneurysm with a thin vessel wall. Therefore, modification of the clipping technique is sometimes needed.
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spelling pubmed-46533272015-12-09 The efficiency of the new Yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm Ota, Nakao Tanikawa, Rokuya Noda, Kosumo Tsuboi, Toshiyuki Kamiyama, Hiroyasu Tokuda, Sadahisa Surg Neurol Int Surgical Neurology International: Cerebrovascular BACKGROUND: The fenestrated clip is sometimes useful in limited approach angle and narrow working space. However, before the development of the new Yasargil titanium fenestrated mini-clip, the only variations of fenestrated clips were those of larger sizes. And those larger clips have a problem of the triangle-shaped gap at the proximal end of the blade. The authors describe the efficiency, limitations and surgical technique of using the Yasargil titanium fenestrated mini-clip. METHODS: Fifty-nine cases of aneurysms were treated using these mini-clips. Aneurysm location, size and dome neck ratio, mean follow-up period, neck remnant, and recurrence rate were also analyzed. Among these cases, we present eight characteristic cases, including a case with aneurysm recurrence, and we review the problems associated with the triangle-shaped gap at the proximal end of the clip. RESULTS: The average size of the aneurysms was 5.57 mm, and the dome neck ratio was >2.0 in 1.69%, >1.5 in 11.8%, >1.2 in 35.6%, and <1.2 in 50.8% of cases. The mean follow-up period for the 59 cases was 5.5 months (range, 0.5–16 months). Angiographic recurrence of the treated portion occurred in 1 case (1.7%), including an aneurysm in the basilar artery tip aneurysm. CONCLUSION: The availability of the Yasargil titanium fenestrated mini-clip increases the options for clipping to minimize the remnant of the clipped aneurysm. However, there is still concern over the triangular space at the base of the blade, especially when treating an aneurysm with a thin vessel wall. Therefore, modification of the clipping technique is sometimes needed. Medknow Publications & Media Pvt Ltd 2015-10-23 /pmc/articles/PMC4653327/ /pubmed/26664871 http://dx.doi.org/10.4103/2152-7806.168072 Text en Copyright: © 2015 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Surgical Neurology International: Cerebrovascular
Ota, Nakao
Tanikawa, Rokuya
Noda, Kosumo
Tsuboi, Toshiyuki
Kamiyama, Hiroyasu
Tokuda, Sadahisa
The efficiency of the new Yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm
title The efficiency of the new Yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm
title_full The efficiency of the new Yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm
title_fullStr The efficiency of the new Yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm
title_full_unstemmed The efficiency of the new Yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm
title_short The efficiency of the new Yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm
title_sort efficiency of the new yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm
topic Surgical Neurology International: Cerebrovascular
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653327/
https://www.ncbi.nlm.nih.gov/pubmed/26664871
http://dx.doi.org/10.4103/2152-7806.168072
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