Preservation of the Arteries around Aneurysm

All of the arteries around the aneurysm, especially perforating arteries, should be preserved when clipping aneurysms. However, perforating arteries often arise close to the aneurysmal neck. And even when great care is taken in dissecting the perforating arteries from the wall of the aneurysm, these arteries move and attach to the sac by the pulsating movement of the cerebrospinal fluid. In these instances, there is little space for the blades of a clip and this makes neck clipping difficult. To avoid the occlusion of the arteries on aneurysmal clipping, we have tried a new technique; that is, we put oxycell cotton between the aneurysmal neck and these perforating arteries, and leave the arteries aside to preserve space for clipping.In this paper, the surgical treatment of aneurysms using this technique is reported. There were 12 cases operated on in the acute stage, (Acom: 5, BA: 3, IC: 2, MC: 1, VA: 1). Neck clipping was performed and the perforating arteries around the aneurysm were successfully preserved by this method. Postoperative CT scanning revealed no low density area, and there were no neurological deficits in any case.This method may be a useful technique for preserving the perforating arteries in aneurysmal surgery.