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Updated: May 17, 2026

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Patterns of aneurysm recurrence after microsurgical clip obliteration
Alejandro M Spiotta1, Ferdinand Hui, Albert Schuette
1Division of Neurosurgery, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina 29425, USA. spiotta@musc.edu
Background:
Microsurgical clip obliteration remains a time-honored and viable option for the treatment of select aneurysms with very low rates of recurrence.
Objective:
We studied previously clipped aneurysms that were found to have recurrences to better understand the patterns and configurations of these rare entities.
Methods:
A retrospective review was performed of 2 prospectively maintained databases of aneurysm treatments from 2 institutions spanning 14 years to identify patients with recurrence of previously clipped intracranial aneurysms.
Results:
Twenty-six aneurysm recurrences were identified. Three types of recurrence were identified: type I, proximal to the clip tines; type II, distal; and type III, lateral. The most common type of recurrence was that arising distal to the clip tines (46.1%), and the least frequently encountered recurrence was that arising proximal to the tines (19.2%). Laterally located recurrences were found in 34.6% of cases.
Conclusion:
We describe 3 different patterns of aneurysm recurrence with respect to clip application: those occurring proximal, distal, or lateral to the clip tines.
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