✓ Twenty-four different kinds of fenestrated clips are introduced for the obliteration of unusual aneurysms. The clips were used for eight aneurysms of the internal carotid artery and 10 aneurysms of the vertebral artery. All but one of the aneurysms were successfully obliterated. Recommendations are made concerning the actual use of the clips.
Kenichiro Sugita, Shigeaki Kobayashi, Kazuhiko Kyoshima and Fukuo Nakagawa
Shigeaki Kobayashi, Kenichiro Sugita and Fukuo Nakagawa
✓ The authors report a case of a basilar artery aneurysm approached by the transsylvian route; the aneurysm was successfully clipped through the space distal to the carotid bifurcation and between the frontal and temporal lobes. This approach is useful when the internal carotid artery is short, sclerotic, and difficult to mobilize. Special care should be taken when retracting perforating arteries and the posterior communicating artery.
Fukuo Nakagawa, Shigeaki Kobayashi, Toshiki Takemae and Kenichiro Sugita
✓ Saccular aneurysms arising at locations other than at arterial divisions are extremely rare. The authors describe eight such aneurysms that protruded from the dorsal wall of the internal carotid artery (ICA) and were unrelated to any arterial junction. Radical surgery was performed in all eight cases. The aneurysms were saccular with a fragile wide or semifusiform neck. Intraoperative rupture occurred in three cases. From this experience, it is emphasized that these unusual protruding aneurysms of the dorsal ICA should be clipped with the clip blade parallel to the parent artery. In addition to clipping, complete wrapping with fascia or Bemsheet (cellulose fabric) is often advisable to prevent slippage of clips or postoperative rupture of residual aneurysm.