Clip-knotting technique for intracranial arterial suturing through deep and narrow surgical corridors-how I do it

One of the most difficult procedures through a deep and narrow surgical corridor is tying a knot following microsuturing, even though microvascular suturing is a fundamental technique for neurovascular surgeons.

A novel technique replacing the conventional knot-tying method was devised. The proposed clip-knotting technique uses an aneurysm clip to hold both remaining ends of a thread that is sutured in a running manner.

The proposed clip-knotting technique can facilitate the microsuturing procedure for intracranial arterial repair in a deep and narrow operative field.