Clip-grafts for aneurysm and small vessel surgery.

1972 ◽  
Vol 37 (6) ◽  
pp. 753-758 ◽  
Author(s):  
Thoralf M. Sundt

✓ Analysis of the use of the clip-graft for intracranial aneurysms indicates that the clip-graft is chiefly applicable to internal carotid and anterior communicating artery aneurysms. The development of the right-angle clip holder has extended its use to anterior communicating artery aneurysms that project posteriorly or superiorly. The dangers of dissection in the septal region are discussed. With few exceptions, the clip-graft is not applicable to the vertebrobasilar system or middle cerebral artery trifurcation aneurysms, although it has been used for aneurysms arising from the trunk of the latter vessel.

1983 ◽  
Vol 58 (6) ◽  
pp. 941-946 ◽  
Author(s):  
Shunichiro Fujimoto ◽  
Masao Murakami

✓ Angiographic and operative investigations revealed an anomalous branch of the internal carotid artery (ICA) in a patient with an anterior communicating artery (ACoA) aneurysm. The anomalous vessel originated from the right ICA at the level of the ophthalmic artery, and pursued an infraoptic and prechiasmatic path to supply both pericallosal arteries. The clinical features and possible genesis of this anomaly are discussed. This irregularity is frequently associated with intracranial aneurysms, especially those of the ACoA, and with other anomalies.


1980 ◽  
Vol 53 (3) ◽  
pp. 300-304 ◽  
Author(s):  
Toshisuke Sakaki ◽  
Kazuhiko Kinugawa ◽  
Tatsuo Tanigake ◽  
Seiji Miyamoto ◽  
Kikuo Kyoi ◽  
...  

✓ Embolism from an aneurysm is one of the mechanisms involved in the pathogenesis of ischemic symptoms associated with intracranial aneurysms. Four cases are reported in which aneurysms of the internal carotid arteries and middle cerebral arteries were the source of emboli resulting in cerebral infarction. In the treatment of these aneurysms, it is best to clip the neck of the aneurysm with great care to avoid embolism due to extrusion of clot into the distal artery.


1991 ◽  
Vol 74 (1) ◽  
pp. 133-135 ◽  
Author(s):  
Kevin Gibbons ◽  
Leo N. Hopkins ◽  
Roberto C. Heros

✓ Two cases are presented in which clip occlusion of a third distal anterior cerebral artery segment occurred during treatment of anterior communicating artery aneurysms. Case histories, angiograms, operative descriptions, and postmortem findings are presented. The incidence of this anomalous vessel is reviewed. Preoperative and intraoperative vigilance in determining the presence of this anomaly prior to clip placement is emphasized.


1980 ◽  
Vol 52 (6) ◽  
pp. 790-793 ◽  
Author(s):  
John F. Alksne ◽  
Randall W. Smith

✓ The authors review 22 consecutive cases of anterior communicating artery aneurysms treated by stereotaxic iron-acrylic occlusion. There was no mortality and no rebleeding in this series. The morbidity was low, and 16 of the 22 patients have returned to work. The patients whose aneurysms could be treated transsphenoidally enjoyed the best outcome.


1981 ◽  
Vol 54 (5) ◽  
pp. 673-676 ◽  
Author(s):  
Yoshihide Nagamine ◽  
Shinichiro Takahashi ◽  
Makoto Sonobe

✓ A case of multiple intracranial aneurysms associated with unilateral moyamoya vessels is reported. The authors have reviewed the age, sex, initial symptoms, site of aneurysm, and operative indication in similar cases reported in the literature. It was found that aneurysms associated with moyamoya disease were frequently located in the vertebrobasilar system.


1978 ◽  
Vol 49 (1) ◽  
pp. 0107-0110 ◽  
Author(s):  
Gulshan K. Ahuja ◽  
Neeraj Jain ◽  
Malini Vijayaraghavan ◽  
Subimal Roy

✓ A young man who had a long history of sinusitis developed subarachnoid hemorrhage and died. Autopsy showed a mycotic aneurysm of fungal origin at the junction of the right posterior cerebral and internal carotid arteries. Four of five reported cases of fungal aneurysm were due to Aspergillus infection.


1988 ◽  
Vol 69 (1) ◽  
pp. 142 ◽  
Author(s):  
Milton D. Heifetz

✓ A new clamp with a flexible cable control mechanism for temporary intraoperative occlusion of the cervical internal carotid artery is described.


1994 ◽  
Vol 80 (4) ◽  
pp. 635-642 ◽  
Author(s):  
Yuichiro Tanaka ◽  
Shigeaki Kobayashi ◽  
Kazuhiko Kyoshima ◽  
Kenichiro Sugita

✓ 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.


2001 ◽  
Vol 95 (5) ◽  
pp. 764-770 ◽  
Author(s):  
Carole L. Turner ◽  
Susan Tebbs ◽  
Piotr Smielewski ◽  
Peter J. Kirkpatrick

Object. Applanation tonometry is a noninvasive method of assessing both peripheral and central arterial blood pressure (BP) profiles. In this study the authors examine whether there are differences in these profiles in patients with intracranial aneurysms when compared with age-matched controls. Methods. Carotid artery (CA) and derived aortic BP waveforms were obtained using a pulse wave analysis system. The ratio of the pressure wave amplitude above the systolic shoulder to the total systolic BP (augmentation index [AI]) was recorded. One hundred seventy-three patients with intracranial aneurysms (23 unruptured lesions) and 173 healthy control volunteers were examined. For the patients with aneurysms the right and left CA AIs (mean ± standard deviation) were 125.6 ± 23.1% and 128.3 ± 22.1%, respectively. Corresponding values for the control group were 118.4 ± 22.6% and 119.4 ± 21.8%. The calculated AI for the ascending aorta was 29.8 ± 10.5% and 25.6 ± 12.2% for patients with aneurysms and control volunteers, respectively. Significant asymmetry in CA AI was seen in patients with aneurysms, the left being greater (p = 0.002). No significant differences were seen in mean BP (108 ± 14 mm Hg in patients with aneurysms compared with 106 ± 16 mm Hg in controls; p = 0.2). Multivariate analysis excluded the influence of BP and other potential confounding vascular risk factors for increased AI. Conclusions. Significant differences in AI, both in magnitude and symmetry, were identified in patients with intracranial aneurysms when compared with matched controls.


1983 ◽  
Vol 59 (3) ◽  
pp. 520-523 ◽  
Author(s):  
Yuichiro Tanaka ◽  
Hideaki Hara ◽  
Genki Momose ◽  
Shigeru Kobayashi ◽  
Shigeaki Kobayashi ◽  
...  

✓ A case of coexisting proatlantal intersegmental artery and primitive trigeminal artery is described. These anomalies were incidental findings in a patient with hemiparesis due to occlusion of the middle cerebral artery. The primitive trigeminal artery had an asymptomatic aneurysm at its origin from the internal carotid artery.


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