我々の行っている種々のクリッピングテクニック

Abstract

Various kinds of complications may happen in association with the clipping surgery of cerebral aneurysms. The sites at which complications occur relate to the following three anatomical structures; I. aneurysm itself, II. parent artery and branches, III. neural tissues. We classified our techniques to avoid complications as follows: A: techniques useful before application of a clip to gain better visualization of the aneurysm neck and surrounding structures, B: selection of clip, C: application of clip, D: techniques after clipping. Especially in this paper, we describe our methods related to C: application of clip. It includes a) multiple clipping, b) formation clipping, c) booster clipping, d) shank clipping, e) compression clipping, f) rotation advance, g) applicator changing, and h) dissection with clip blade. To know these techniques systematically and beforehand would be more helpful in successfully clipping a given aneurysm than trying to find a method at the time of difficulty.