SURGICAL TREATMENT: CLIPPING
Surgery poses the lowest risk when it is performed before an aneurysm ruptures. The patient’ s condition, the size and location of the aneurysm, and other factors determine the risk of surgery. Your doctor will discuss the risks and benefits of surgery with you and your family and answer any questions you may have.
Clipping is an open surgical procedure to seal off the aneurysm neck and, thus, prevent blood from entering the aneurysm, which obliterates it. Clipping of brain aneurysms has been available longer than endovascular therapy, and has excellent long-term results. In recent years, titanium clips have generally been used. These are MRI compatible and they will not set off alarms at metal detectors.
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The Procedure
A patient undergoing aneurysm surgery seldom requires blood replacement. If necessary, blood from the blood bank is used. You can also donate your own blood before the procedure, or have family members donate if you prefer.
This surgery is done under general anesthesia, so patients meet with an anesthesiologist before the procedure and are asked questions about their medical history.
A team of doctors, led by a neurosurgeon, performs the clipping procedure. This is an open surgery, which means the skull is cut and microsurgery is performed. Part of the preparation for this surgery may include shaving a section of the hair on your head.
The neurosurgeon makes an incision behind the hairline or on the back of the head, depending on the location of the aneurysm. From there a section of bone, or bone plate, is removed( craniotomy) from the skull to expose the brain tissue.
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