title: Combined suture and clipping for the reconstruction of a ruptured blister-like aneurysm.
abstract: Blister-like aneurysms of the internal carotid artery (ICA) present a severe therapeutical challenge. While several reconstructive techniques are in use in case of acute rupture sacrifice of the parent vessel may be required. We present a combined technique of micro-sutures and clip application to repair the parent vessel in an intraoperatively ruptured blister-like aneurysm. Following temporary trapping of an intraoperatively ruptured 7-mm blister-like aneurysm four 8-0 nylon sutures were applied to adapt the vessel walls and support the branches of subsequently applied mini-clips. The combination of micro-sutures and mini-clips might be a valuable alternative to direct clipping or suturing in some cases with intraoperative rupture of blister-like aneurysms.
authors: Department of Neurosurgery, University Medical Centre, Johannes Gutenberg-University, Langenbeckstr. 1, 55129, Mainz, Germany. sven.kantelhardt@unimedizin-mainz.de.
authors: Sven R
authors: SR
authors: Kantelhardt
authors: Department of Neurosurgery, University Medical Centre, Johannes Gutenberg-University, Langenbeckstr. 1, 55129, Mainz, Germany.
authors: Eleftherios
authors: E
authors: Archavlis
authors: Department of Neurosurgery, University Medical Centre, Johannes Gutenberg-University, Langenbeckstr. 1, 55129, Mainz, Germany.
authors: Alf
authors: A
authors: Giese
mesh_terms: D017542:Aneurysm, Ruptured / Q000601:surgery*; D001768:Blister / Q000473:pathology; D002343:Carotid Artery, Internal / Q000473:pathology / Q000601:surgery; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013525:Surgical Instruments / Q000009:adverse effects*; D013537:Sutures / Q000009:adverse effects*
keywords: Blister-like aneurysms; Clipping; Micro-suture; Rupture; SAH; Surgery