Abstract
Neck clipping was performed on 835 aneurysms (698 cases) in our institute from April 1976 till December 1985, and postoperative recurrent hemorrhage occured in seven cases (0.8%).
It was presumed that postoperative recurrent hemorrhage was due to the“incomplete clip in four cases and due to the“slipped clip”in three cases. Three aneurysms that were treated by neck clipping combined wiht coating because of the inability to obliterate the neck completely, rebled 24-57 days after the operation. It is doubtful, in those cases, whether the best coating material was selected and whether the aneurysmal portion was covered entirely.
One case was a so called“miss clip”
In three cases, slippage of the tip of the blade was observed at the reoperation. The“slipped clip”was caused by a) selection of an inappropriate clip for a given aneurysm or b) inaccurate clip placement.
As postoperative blood pressure was high in six cases, hypertension might have partially caused the rupture of the residual neck or the slip off of the aneurysm clip.
