title: Rebleeding from clipped aneurysm after 35 years: Report of 2 cases.
abstract: BACKGROUND
  A successfully applied clip for a ruptured aneurysm keeps the aneurysm's neck closed, preventing rerupture throughout the patient's life. Unfortunately, rebleeding from a clipped aneurysm does occur, but the likelihood declines with time. Since relatively old people suffer from subarachnoid hemorrhage, they die from diseases other than rebleeding, such as cancer. Therefore, rebleeding from a clipped aneurysm after two decades is quite rare.
  
  
  METHODS
  Here, we report 2 cases of rerupture after an extremely long time since the initial clipping. In both cases, the old clip was removed, and the regrown gourd-shaped aneurysm was successfully obliterated. The clips in both cases were submitted to their manufacturers and inspected thoroughly. They were found to be second-generation, stainless steel clips, and were almost intact, even keeping their closing forces. In both cases, the clip existed on the surface of the newly made dome, and the previous dome completely disappeared.
  
  
  CONCLUSIONS
  We experienced 2 cases of rebleeding from the clipped aneurysm after 35 years. In one of the cases, the clip was a Yasargil second generation stainless steel clip that retained its mechanical properties and surface elemental composition in vivo for a long time. These cases should be informative as they show extremely long-term course of a clip applied for a ruptured aneurysm.
authors: Department of Neurosurgery, Moriyama Memorial Hospital, Tokyo, Japan.
authors: Atsushi
authors: A
authors: Ishida
authors: Department of Neurosurgery, Moriyama Memorial Hospital, Tokyo, Japan.
authors: Seigo
authors: S
authors: Matsuo
authors: Department of Neurosurgery, Moriyama Memorial Hospital, Tokyo, Japan.
authors: Keizoh
authors: K
authors: Asakuno
authors: Department of Neurosurgery, Moriyama Memorial Hospital, Tokyo, Japan.
authors: Akio
authors: A
authors: Nemoto
authors: Department of Neurosurgery, Moriyama Memorial Hospital, Tokyo, Japan.
authors: Kaku
authors: K
authors: Niimura
authors: Department of Neurosurgery, Moriyama Memorial Hospital, Tokyo, Japan.
authors: Haruko
authors: H
authors: Yoshimoto
authors: Department of Neurosurgery, Moriyama Memorial Hospital, Tokyo, Japan.
authors: Hideki
authors: H
authors: Shiramizu
authors: Department of Neurosurgery, Moriyama Memorial Hospital, Tokyo, Japan.
authors: Miki
authors: M
authors: Yuzawa
keywords: Long-term follow-up; rebleeding; subarachnoid hemorrhage