title: A combined surgical-endovascular device concept for giant aneurysm neck occlusion.
abstract: OBJECTIVE
  In this report, we describe a new multimodality device concept for occluding giant aneurysms. The device is designed to exploit the advantages, and avoid the disadvantages, of conventional microneurosurgery and interventional neuroradiology methods.
  
  
  METHODS
  Our device concept involves surgically placing small permanent magnets, incorporated into a partially occluded magnetic clip, about the extraluminal neck without mechanically compromising the perforating vessels. These magnets serve as optimally positioned anchor points for ferromagnetic materials subsequently introduced via the endovascular route.
  
  
  BACKGROUND
  Currently, neurosurgical extraluminal obliteration of giant aneurysms is achieved by mechanically closing the aneurysm neck with metal clip blades, which is a technique that risks inadvertent occlusion of critical perforating vessels. Perforating vessel strokes can largely be avoided using endovascular aneurysm occlusion methods. However, in the setting of the giant aneurysm, these endovascular techniques are associated with high rates of incomplete occlusion.
  
  
  CONCLUSIONS
  Preliminary feasibility tests of this concept were conducted using a simple prototype constructed in our laboratories.
authors.affiliation: Division of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Wellman
authors.forename: C M
authors.initials: CM
authors.lastname: Loftus
authors.forename: D
authors.initials: D
authors.lastname: Noh
authors.forename: W H
authors.initials: WH
authors.lastname: Barnhart
authors.forename: M A
authors.initials: MA
authors.lastname: Howard
mesh_terms: D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy*; D000792:Angiography; D000818:Animals; D004285:Dogs; D005240:Feasibility Studies; D005263:Femoral Artery / Q000000981:diagnostic imaging; D007501:Iron; D008280:Magnetics; D008488:Medical Illustration; D008863:Microspheres; D008955:Models, Cardiovascular; D009493:Neurosurgery / Q000379:methods*; D011138:Polytetrafluoroethylene
chemical_list: D011138:Polytetrafluoroethylene; D007501:Iron