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Multiple clipping technique for large and giant internal carotid artery aneurysms and complications: angiographic analysis

Yuichiro Tanaka Departments of Neurosurgery, Shinshu University School of Medicine, Matsumoto, and Nagoya University School of Medicine, Nagoya, Japan

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 M.D.
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Shigeaki Kobayashi Departments of Neurosurgery, Shinshu University School of Medicine, Matsumoto, and Nagoya University School of Medicine, Nagoya, Japan

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 M.D.
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Kazuhiko Kyoshima Departments of Neurosurgery, Shinshu University School of Medicine, Matsumoto, and Nagoya University School of Medicine, Nagoya, Japan

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 M.D.
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Kenichiro Sugita Departments of Neurosurgery, Shinshu University School of Medicine, Matsumoto, and Nagoya University School of Medicine, Nagoya, Japan

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 M.D.
Page Range:
635–642
Volume/Issue:
Volume 80: Issue 4
DOI link:
https://doi.org/10.3171/jns.1994.80.4.0635
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✓ Experience with surgical clipping of 16 large and nine giant aneurysms of the intradural internal carotid artery (ICA) is described. Reconstruction of the parent artery with part of the aneurysmal wall was necessary in the majority of cases. Multiple clips were required for satisfactory clipping in 20 cases. Complications related to the clipping procedure comprised occlusion and stenosis of the parent carotid artery in isolated cases. Straightening of the parent carotid artery with consequent kinking of the middle cerebral artery was seen in three cases of an aneurysm with a dome directed ventrally in the proximal segment of the ICA. The factors that caused straightening of the ICA are analyzed. It was observed that an excessive change in the direction of the ICA can cause cerebral infarction.

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Volume 80: Issue 4

Contributor Notes

Address reprint requests to: Yuichiro Tanaka, M.D., Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390, Japan.
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