Utility of Single Fenestrated Miniclip in Management of Small Cerebral Aneurysm: Technical Report of 2 Cases.
BACKGROUND
Fenestrated miniclips were developed as an effective tool for dog-ear-shaped remnants of aneurysms. However, the special property of these clips may have other applications. Here, we report 2 cases of ruptured small aneurysm and suggest the alternative utility of a single application of a fenestrated miniclip.


CASE DESCRIPTION
A 77-year-old woman was admitted to our hospital with subarachnoid hemorrhage due to an anterior communicating aneurysm. The aneurysm was treated with surgical clipping via a right pterional approach. Because dissection of tight adhesion between the aneurysm and ipsilateral A2 might cause intraoperative bleeding, the angled fenestrated miniclip was applied across the ipsilateral A2 without dissection of adhesion and obliterated the aneurysm without complications. In another case, a 60-year-old man presented with subarachnoid hemorrhage due to ruptured vertebral artery-posterior inferior cerebellar artery (PICA) aneurysm and was treated with surgical clipping via a far-lateral approach. Because aneurysm visualization was impeded by PICA even after mobilization of the PICA and vertebral artery, a fenestrated standard-clip was applied across the PICA. However, this clip impeded visualization of the aneurysm and could not be opened in the tight surgical field. In contrast, subsequent application of a fenestrated miniclip allowed better visualization of the aneurysm, even in a tight field, and resulted in successful obliteration of the aneurysm.


CONCLUSION
Single application of fenestrated mini-clips may be suitable in cases of small aneurysms with thin walls adhering to branch vessels or where visualization of the aneurysm is impeded by the parent artery.
['Akamatsu|Yosuke|Y|', 'Kashimura|Hiroshi|H|', 'Suzuki|Taro|T|', 'Aso|Kenta|K|', 'Oshida|Sotaro|S|']
D000368:Aged D017542:Aneurysm, Ruptured D000072226:Computed Tomography Angiography D003399:Craniotomy D004867:Equipment Design D005260:Female D006801:Humans D002532:Intracranial Aneurysm D008297:Male D008875:Middle Aged D019635:Neurosurgical Procedures D013345:Subarachnoid Hemorrhage D013525:Surgical Instruments D016896:Treatment Outcome
Fenestrated miniclip Aneurysm Clipping