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.3171/jns.1986.64.5.0822 Miniclips and microclips for surgical hemostasis Thoralf M. Sundt Jr. George Kees Jr. May 1986 64 5 824 825 10.3171/jns.1986.64.5.0824 J Neurosurg Journal of Neurosurgery 0022-3085 Journal of Neurosurgery Publishing Group 1 5 1986 May 1986 64 5 10.3171/jns.1986.64.issue-5

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Thoralf M. Sundt Jr. and George Kees Jr.

worsening the neurological deficit. It is often necessary to occlude a small perforating vessel in a limited space with a small aneurysm clip. The length of the smallest aneurysm clip currently available approximates 9 mm. This is far too large a clip to place in the depth of the wound as it obscures other bleeding points and interferes with the remaining portion of the procedure. To solve this problem, we have designed a miniclip and a microclip for use in these situations. Design and Use of Clips The miniclip is approximately 3 mm in length and is constructed of

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Kenichiro Sugita, Shigeaki Kobayashi, Toshiki Takemae, Tsuyoshi Tada and Yuichiro Tanaka

unsuccessful because a large portion of the neck and body was located behind the artery, which limited the direction of application. The clip was shifted a little deeper because its blades were open due to the thick wall of the aneurysm. A second bayonet clip of the same length as the first was added on the side of the aneurysm to reinforce the closing pressure. Finally, the small aneurysm on the distal basilar artery was obliterated with a miniclip, 5 mm in length, and wrapped with two pieces of Bemsheet and fibrin glue to prevent the clip from slipping. The third small

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Argon laser-induced arterial photothrombosis

Characterization and possible application to therapy of arteriovenous malformations

Brant D. Watson, W. Dalton Dietrich, Ricardo Prado and Myron D. Ginsberg

neurosurgery. J Neurosurg 60: 523–530, 1984 21. Rawls HR , Van Santen PJ : A possible role for singlet oxygen in the initiation of fatty acid auto-oxidation. J Am Oil Chem Soc 47 : 121 – 125 , 1970 Rawls HR, Van Santen PJ: A possible role for singlet oxygen in the initiation of fatty acid auto-oxidation. J Am Oil Chem Soc 47: 121–125, 1970 22. Sundt TM Jr , Kees G Jr : Miniclips and microclips for surgical hemostasis. Technical note. J Neurosurg 64 : 824 – 825 , 1986 Sundt TM Jr, Kees

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Samuel F. Ciricillo, Richard L. Davis and Charles B. Wilson

caudally above the ninth and 10th nerves into the cisterna magna. The multiperforated, radiopaque tip of a Pudenz ventricular catheter was advanced through the cyst into the lateral cistern near the trigeminal root. The caudal end was passed through the lower fenestration in the cyst wall and placed in the cisterna magna. An encircling suture, which had been placed near the caudal end of the catheter before insertion, was fixed to the adjacent dura with a Weck miniclip. Postoperative Course The patient's symptoms resolved in the immediate postoperative period

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John L. D. Atkinson, John I. Lane, Harold J. Colbassani and D. Mark E. Llewellyn

thalamoperforating artery was dissected from the medial fundus wall of the aneurysm and a straight 6-mm Sundt-Kees aneurysm clip was placed between the aneurysm and the posterior thalamoperforating trunk. The aneurysm softened considerably so it could be dissected; it was found to be fusiform without an identifiable neck. Because of the small working area, the aneurysm was trapped by placing a slim 6-mm Sundt-Kees miniclip immediately distal to it. The aneurysm was then incised and decompressed. No filling of the exenterated aneurysm from posterior-wall perforating vessels could

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Marvin Bergsneider, John G. Frazee and Antonio A. DeSalles

aneurysm (arrow) lying in the anterior inferior portion of the third ventricle. The intraventricular hemorrhage had by this time resolved. Operation . A right pterional-frontal craniotomy was performed. The sylvian fissure was partially opened, and the PCoA and its branches were identified. The lamina terminalis was then opened via a subfrontal approach, immediately exposing a thin-walled saccular aneurysm. The neck of the aneurysm appeared to be flush with the right anterolateral wall of the third ventricle. Attempted application of a Yaşargil miniclip to the

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Axel Perneczky and Georg Fries

. All fenestrated clips have openings of either 3.5 mm or 5.0 mm. Temporary clips of various shapes and sizes are also available. The blade length is 3 to 18 mm, the opening width of the distal tip of the clip blades varies between 3.3 mm and 12 mm, and the closing pressures of the blades are 100 g ± 10% in micro- and miniclips, and 130 g ± 15% in standard clips. Description of the Clip Holder and Clip Remover The bayonet-shaped clip holder has a total length of 220 mm; the joint is located at a distance of 12 mm from the distal tip of the jaws. The outer

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François Proust, Françoise Callonec, Francis Bellow, Annie Laquerriere, Didier Hannequin and Pierre Fréger

aneurysm was trapped between hemostatic miniclips and excised along with a 2-mm segment of the SCA. Pathological Findings The aneurysm was removed for pathological examination. Histological sections of the excised tissue revealed a false aneurysm formed by fibrous tissue and organized hematoma ( Fig. 4 ). Fig. 4. Photomicrographs. Upper: Section of the aneurysm sac showing an organized blood clot (A). The clot is covered by an inflammatory reaction and connective tissue (B). H & E, original magnification × 100. Lower: Fragment of the internal elastic

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Takeo Goto, Kenji Ohata, Toshihiro Takami, Misao Nishikawa, Naohiro Tsuyuguchi, Michiharu Morino, Yasuhiro Matusaka, Akimasa Nishio, Yuichi Inoue and Mitsuhiro Hara

left and one of large size on the right at this level. At 6 months after surgery, new bone formation was observed from the vertebral side to the spacer, especially on the left; at 12 months, bone union was observed bilaterally. Lower Row: A preoperative CT scan at C-4 demonstrated a cervical ependymoma. Small-sized HA spacers were placed bilaterally. At 6 months some new bone formation from the vertebral side to spacer was observed bilaterally. At 12 months bone union was demonstrated around the spacers. Titanium miniclips used for dural closure are seen as small