title: Interlocking-clipping technique for giant aneurysms of the internal carotid artery: technical case report.
abstract: OBJECTIVE
  Direct clipping of giant intracranial aneurysms is sometimes difficult. A unique technique using multiple fenestrated clips for closing a giant aneurysm is described.
  
  
  METHODS
  A 65-year-old woman presented with a 10-month history of headache and gait disturbance. Cerebral angiography disclosed an unruptured giant aneurysm of the right internal carotid artery.
  
  
  METHODS
  Surgical exposure confirmed the presence of a giant aneurysm with the splaying and incorporation of the parent artery and a number of perforating arteries originating from the dome. Four angled and three straight fenestrated clips were applied in tandem to the aneurysm to reconstruct the parent artery and preserve the perforating vessels. Through their blades and heads, the closely arranged clips were successfully interlocked.
  
  
  CONCLUSIONS
  This "interlocking-clipping" technique is a modification of the tandem clipping technique. The aim of this approach is to enhance closing pressure and allow a more stable "seating" of the clips in giant cerebral aneurysms.
authors.affiliation: Department of Neurosurgery, Okanami General Hospital, Ueno, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Hashimoto
authors.forename: J
authors.initials: J
authors.lastname: Iida
authors.forename: K
authors.initials: K
authors.lastname: Masui
authors.forename: T
authors.initials: T
authors.lastname: Yonezawa
authors.forename: T
authors.initials: T
authors.lastname: Sakaki
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D013525:Surgical Instruments