title: Endurance of aneurysm clips: mechanical endurance of Yaşargil and Spetzler titanium aneurysm clips.
abstract: OBJECTIVE
  To determine whether repeated use weakens titanium aneurysm clips, making them unsafe for clinical use.
  
  
  METHODS
  Nine Yaşargil (titanium alloy) and five Spetzler (pure titanium) clips were subjected to clinically relevant maneuvers, and the effects on the closing force were assessed. Clips were considered unsafe if 1) the blades crossed, 2) the clips failed to close completely, or 3) the blood pressure could open them.
  
  
  RESULTS
  Yaşargil and Spetzler clips significantly (P < 0.01 for both) weakened, by 18.9% and 26.1%, respectively, after 10 minutes of sustained maximal opening. After 100 open-close cycles, Spetzler clips showed no change in closing force, but the closing force of Yaşargil clips decreased significantly (P < 0.01), by a further 12.0%.
  
  
  CONCLUSIONS
  Repeated use weakens Spetzler and Yaşargil clips. All Spetzler and all but one Yaşargil clips were deemed safe for clinical use at the end of the experiments.
authors.affiliation: Department of Neurosurgery, Hurstwood Park Neurological Centre, Princess Royal Hospital, Haywards Heath, West Sussex, England, U.K.
authors.forename: Marios C
authors.initials: MC
authors.lastname: Papadopoulos
authors.forename: Vinothini
authors.initials: V
authors.lastname: Apok
authors.forename: Frederick T
authors.initials: FT
authors.lastname: Mitchell
authors.forename: David P
authors.initials: DP
authors.lastname: Turner
authors.forename: Adrian
authors.initials: A
authors.lastname: Gooding
authors.forename: John
authors.initials: J
authors.lastname: Norris
mesh_terms: D000497:Alloys; D001696:Biomechanical Phenomena / Q000706:statistics & numerical data; D004867:Equipment Design; D019544:Equipment Failure Analysis / Q000706:statistics & numerical data; D017743:Equipment Reuse / Q000706:statistics & numerical data; D004869:Equipment Safety / Q000706:statistics & numerical data; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008432:Mathematical Computing; D013242:Sterilization / Q000706:statistics & numerical data; D013525:Surgical Instruments; D014025:Titanium
chemical_list: D000497:Alloys; C031462:titanium alloy (TiAl6V4); D014025:Titanium