Histological change in permanently clipped or ligated cerebral arterial wall

Abstract

In this paper, we discuss the results of a study by light microscope of the effect of permanent clipping or ligation on the intracranial arteries of 38 operation dogs and 7 control dogs. The findings obtained are: 1. In the cerebral arterial circle, necrosis could easily result from ordinary clipping or ligation because of scarce vasa vasorum. 2. As for the incidence of necrosis, the greatest was found in the case of the Yaşargil clip after electric coagulation, next came the Yaşargil clip alone, next ligation, and last the silver clip. The degree of necrosis correlated with the duration of clipping in the cases treated with a spring type clip, and was influenced more by the closing strength at the time of application in the cases with non-spring type clips or ligation. 3. In some of the cases ligated for long duration, recanalization was caused by the passage of the ligature through the vessel wall, suggesting that ligation is not a certain procedure if it is applied alone. 4. The granulation tissue round the clip and ligature began to grow after one month. As for its degree, the most marked granulation was that caused by the silver clip, next the ligature, than the Yaşargil clip after electric coagulation, and finally the Yaşargil clip used normally; in all of them the correlation with the passage of time was noted. 5. In the group of duration three months or more, concentric intimal proliferation was noted peripheral to the clip, and intimal proliferation was also noted exclusively localized to the side of a branch on the central or truncal side of a clip. This correlated in degree with the passage of time. 6. Clipping and ligation are liable to cause necrosis and fragmentation, but on the other hand it was considered that rupture of the vessel wall did not result because of the reinforcing and reparative effect of the reactive granulation tissue and the intimal proliferation which developed in such a manner as to strengthen the area involved.

Bare, Bio-Active and Hydrogel-Coated Coils for Endovascular Treatment of Experimentally Induced Aneurysms

“…Despite these new techniques, the major argument that still spoke in favor of surgical ligation of the aneurysm instead of endovascular occlusion was that the surgical clip approximates two healthy vessel walls close to each other thereby excluding the weakened vessel wall, i.e. the aneurysm, from the circulation and reconstructing the normal vessel wall 3,4 . Endovascular techniques, on the other hand, did not demonstrate a complete neoentholialization of the coil loops over the former aneurysm ostium.…”

Cell-mediated allergy to cerebral aneurysm clip causing extensive cerebral edema

“…The Phynox aneurysm clip is a safe and effective option in the treatment of intracranial aneurysms, with well-studied histological, 2 mechanical, and biochemical properties. 6 However, there is theoretical concern regarding the likelihood of allergic reactions to metallic clip components, most notably to nickel.…”

Perspective Chapter: Role of Direct Surgery for Recurrent Aneurysms after Endovascular Treatment

“…Since then, craniotomy clipping results have improved with the advent of the latest cerebral aneurysm clips and surgeon skill improvements. Many neurosurgeons have accepted this as a highly reliable long-term procedure with a low recurrence rate for unruptured and ruptured cerebral aneurysms [3][4][5]. The most significant advantage of this treatment is that it immediately…”