Double-clip technique: An effective clipping technique for small and very small aneurysms

Area of Science:

• Neurosurgery
• Vascular Surgery
• Microsurgery

Background:

• Presents a double-clip technique for managing small (≤5 mm) and very small (≤3 mm) aneurysms.
• This technique is a parallel duplication of booster clipping using mini-clips with reduced closing force.
• It prevents clip slippage and has a proven safety and efficacy record.

Purpose of the Study:

• To demonstrate the double-clip technique for aneurysm management.
• To highlight its effectiveness in preventing clip slippage and ensuring secure occlusion.

Main Methods:

• A left lateral supraorbital approach was used for a small paraclinoid aneurysm.
• Adenosine-induced cardiac arrest was employed for proximal control, avoiding conventional temporary clipping.
• A parallel double mini-clip application technique was performed to secure the aneurysm neck.

Main Results:

• The double-clip technique successfully occluded the small aneurysm.
• Postoperative computed tomography angiography confirmed the absence of complications.
• This method ensures proper occlusion by preventing slippage and utilizing synergistic clip force.

Conclusions:

• The double-clip technique, a variation of booster clipping, is effective for small and very small aneurysms.
• It provides secure occlusion and prevents clip slippage.
• This method is a valuable addition to aneurysm clipping procedures.