Abstract
The treatment of regrowing aneurysms some years after neck clipping is challenging for neurosurgeons, because severe adhesion is inevitable in the operative field, especially around the previous clip. This obstructs the dissection around the aneurysmal neck and also the clipping itself.
Removal of the previous clip without rupture of aneurysms is optimal but remains controversial. In this report, we presented 3 successful cases whose regrowing aneurysms were precisely clipped again by removing the previous spring clips, which were placed 10, 17 and 18 years before respectively. We used the same approach as the previous one to remove the clip. The key point to remove the clips was the sharp dissection of the tough granulomatous tissue surrounding the clip. After that, the clips could be easily loosened and removed by the clip applier without rupture. When the clip was reinforced by coating materials, the meticulous and complete dissection around the clip was necessary to avoid injury of the aneurysmal wall.
