A Wrap and Clip Technique for Treating Cerebral Aneurysms

Abstract

We reviewed 2 cases of unclippable unruptured cerebral aneurysms treated using a wrap and clip method and report the findings and techniques used. A 55-year-old woman with a middle cerebral artery fusiform aneurysm underwent a wrap and clip procedure. The aneurysm was covered with two pieces of Gore-Tex sling and clipped using the Weck clip, and several Weck clips were then added to pack the space between the aneurysm and the surrounding Gore-Tex sling. A 39-year-old man developed a pseudoaneurysm at the A2 segment of the anterior cerebral artery. A Gore-Tex sling was applied to the entire parent artery and to the pseudoaneurysm circumferentially and was clipped with the proximal portion of the aneurysm. Then the Gore-Tex sling and a residual portion of the aneurysm was clipped with another clip in tandem to prevent the clip from slipping out of the sling. The wrap and clip technique resulted in a favorable outcome in both cases, without any observed aneurysm growth or rupture for 61 and 2 months after the procedure, respectively. We believe the wrap and clip method confers protection from aneurysm growth or rupture in cases of unclippable unruptured cerebral aneurysms.