New semicircular clip for internal carotid artery aneurysms. Technical note

Area of Science:

• Neurosurgery
• Vascular Surgery
• Medical Device Innovation

Background:

• Clipping internal carotid artery (ICA) aneurysms can risk damaging important branches like the anterior choroidal or posterior communicating arteries.
• Aneurysm necks are often positioned posteriorly, complicating surgical visualization and increasing the risk of inadvertent clipping of adjacent structures.
• Traditional fenestrated clips may obscure critical ICA branches during closure, leading to potential misclipping.

Observation:

• The development of a specialized semicircular clip designed to overcome the limitations of standard clipping techniques.
• This clip allows for insertion over the ICA, facilitating reconstruction and minimizing residual aneurysm neck.
• The semicircular design aims to improve visualization and prevent inadvertent damage to ICA branches.

Findings:

• The semicircular clip was successfully used in six patients (four with ruptured, two with unruptured ICA aneurysms).
• Complete aneurysm clipping without residual neck was achieved in all cases.
• Preservation of all critical ICA branches was confirmed in every patient treated.

Implications:

• This clip is particularly beneficial for treating ICA aneurysms with posterior or medial projections.
• It offers a safer and more effective method for complex ICA aneurysm clipping.
• The technique enhances the ability to preserve neurovascular structures during cerebrovascular surgery.