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Updated: May 7, 2026
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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Microsurgical clipping of previously coiled aneurysms
Pablo Augusto Rubino1, Jorge Mura2, Martin Kitroser3
1Division of Neurosurgery, Department of Cerebrovascular Surgery, Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina.
World Neurosurgery
|September 24, 2013
Summary
Surgical management of previously coiled aneurysms presents a significant neurosurgical challenge. Careful patient selection and preoperative planning are crucial for successful outcomes in these complex cases.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Interventional Neuroradiology
Background:
- Endovascular coiling is a common treatment for aneurysms.
- Incomplete or recanalized aneurysms after coiling necessitate further intervention.
- Surgical management of previously coiled aneurysms is an emerging challenge.
Observation:
- A series of 20 patients (12 female, 8 male, average age 43.5) underwent surgery for previously coiled aneurysms.
- Reasons for surgery included partially occluded (13) and recanalized (7) aneurysms.
- Aneurysms were located in various cerebral arteries, including anterior communicating artery, posterior communicating artery, middle cerebral artery, paraclinoid carotid artery, and pericallosal artery.
Findings:
- No mortality was observed in the series.
- One patient experienced a mild postsurgical frontal infarction.
- Eight patients required partial coil removal to facilitate successful microsurgical clipping; one required partial clipping and packing due to an arterial branch at the neck.
Implications:
- Surgical intervention for previously coiled aneurysms is complex and carries risks.
- Partial coil removal may be necessary but is not ideal.
- Thorough patient selection and meticulous preoperative planning are essential to minimize the need for surgical retreatment.
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