Metallurgical evaluation of the compatibility of surgical clips with their appliers

Five aneurysm clips and their respective appliers (Heifetz, Vari-Angle, McFadden, Scoville, and Yasargil) were tested for the production of small metal shards that could provoke a foreign body reaction or increase the risk of a stress-corrosion failure. Pivot and Vari-Angle-McFadden clips produced numerous large shards, the Scoville clip produced a few fine shards, and the Yasargil and Heifetz clips produced none. Metal shard production due to cold metal transfer is attributed to the abrasive mechanical interaction between clips and appliers made from metals with different degrees of hardness.