Abstract
We describe our experiences with surgical clipping of 17 large aneurysms. The location of these aneurysms were 7ICAs (including 2 IC-ophthalamic non-ruptured cases), 7MCAs, 2ACAs, and 1BA. The postoperative outcome was GR, 6; MD, 5; SD, 3; D, 3. Three of 6 poor outcome cases were IC aneurysm. A total of 34 clips were used for clipping (average 2 clips in each case), and fenestrated clips were particularly useful in such cases. The causes of poor outcome were operative procedure in 3, spasm in 2, and primary brain damage in 1. In the preoperative examination, 3DCT virtual endoscopy was useful for a successful clipping.
To improve the postoperative outcome for large aneurysms, prevention of premature rupture and an optimal obliteration of aneurysm with the preservation of afferent and efferent arteries as well as perforating vessels are important.
