Surgical treatment | Clipping of a cerebral aneurysm
If the treatment of an aneurysm by means of an endovascular approach (coiling) is not possible or appropriate, the aneurysm can be "clipped" . This surgery is a more traditional treatment of cerebral aneurysms which, however, has proven its effectiveness and safety. After the skull is opened, the aneurysm in the brain is dissected and closed with a titanium clip. Such a clip looks like a small peg which is placed on which the transition between the aneurysm and the normal blood vessel where the aneurysm originated on (aneurysm neck). As a result, the aneurysm is closed off from the blood circulation. This form of surgery is relatively safe and has a low risk for a small aneurysm (5% complication). For a larger aneurysm or an aneurysm that is located in an important area of the brain, such as for example, the brain stem, the risk of the operation is much higher (20 to 30% complication).
The clips are very effective in taking out an aneurysm. The emergence of a regrowth of an aneurysm after an adequate clipping is smaller than 1%. This is one of the biggest advantages over endovascular coiling. In addition, after clipping only one angiographic follow-up is required.
The main disadvantage of the clipping is of course the brain operation itself (including scarring, infection, bleeding) and the risk of brain damage. Fortunately, this is in most aneurysm clippings still relatively low.