Brain aneurysm clipping is a complex procedure used by cerebrovascular surgeons to treat ruptured and unruptured brain aneurysms.
Our cerebrovascular experts have years of experience performing complex brain surgery like brain aneurysm clipping. They work within a multidisciplinary team of highly-trained specialists. This team evaluates your case, considers all your treatment options and recommends the approach best suited to your needs.
What Is Aneurysm Clipping?
Brain aneurysm clipping is a type of microsurgery in which a metal surgical clip is used to close off an aneurysm in the brain. The surgeon makes a small opening in your skull to reach your brain. They use an operating microscope and very small instruments to perform detailed surgical procedures. Precision is key during microsurgery to avoid harming nerves, blood vessels and brain tissue.
In aneurysm clipping surgery, the surgeon:
- Opens a window of bone in the skull.
- Isolates the blood vessel and aneurysm from the surrounding brain tissue.
- Places a metal clip across the aneurysm’s neck.
- Replaces the bone and closes the incision.
The clip effectively cuts off blood flow from the artery to the aneurysm.
Understanding Cerebral Aneurysms and Their Impact on the Brain
A brain aneurysm, also called a cerebral aneurysm, is a weak spot in the wall of an artery that balloons out. Most aneurysms in the brain look like a round sac off the side of the artery. The neck of the aneurysm between the artery and sac can be narrow or wide, and is the typical target of an aneurysm clip.
The greatest risk of a brain aneurysm is that it will rupture and cause a life-threatening hemorrhagic stroke. About half of people who experience a stroke due to a ruptured aneurysm die within three months. Aneurysm clipping procedures close off the cerebral aneurysm to prevent blood from entering the spaces around the brain that may lead to a stroke.
How Effective Is Aneurysm Clipping?
For an unruptured aneurysm, clipping usually provides an effective resolution to the problem. For ruptured aneurysms, clipping can stop the bleeding and prevent another bleeding in the future. However, brain damage that occurred prior to treatment may cause long-lasting disability.
Other Options for Brain Aneurysm Treatment
Aneurysm clipping is one of several options for treating aneurysms. The other main treatment is coiling, a type of endovascular neurosurgery. In endovascular neurosurgery, doctors use thin tubes called catheters to treat cerebrovascular diseases from inside the blood vessels.
Coiling involves injecting thin, soft, metal wires into the aneurysm. The coils reduce blood flow into the aneurysm sac and promote clotting. This process seals the aneurysm off from the artery and reduces the risk of rupture.
Aneurysm Clipping vs. Endovascular Coiling
Compared with aneurysm clipping, endovascular coiling is a minimally invasive procedure. Typically, a less invasive procedure leads to a reduced hospital stay and quicker recovery. While this is an important benefit, endovascular coiling is not the best option in all cases.
Our cerebrovascular experts consider many factors in determining the right treatment for you, including:
- Aneurysm size and shape: Clipping may be more effective for larger aneurysms and those with wide necks.
- Location: Aneurysms located closer to the outer surface of the brain may be easier to access with microsurgery. Doctors often use endovascular treatment to treat deeper aneurysms they cannot reach with microsurgery.
- Rupture: For ruptured aneurysms, you may need microsurgery to remove blood and relieve pressure on the brain. In this case, the surgeon can clip the aneurysm at the same time.
- Your age and health: If you are older or have other health conditions, you may be at higher risk of complications from microsurgery. We may therefore recommend an endovascular approach.
Postsurgical Care After an Aneurysm Clipping Procedure
Following surgery, you will immediately go to our neurocritical care unit for observation. Penn has a large, dedicated neurocritical care team. They manage your immediate recovery in partnership with your surgeon.
Penn Medicine is renowned for excellence in clinical care and research. That expertise extends to postsurgical care. For example, our doctors recently developed an innovative strategy to treat vasospasm, a postsurgical complication that can occur after a hemorrhagic stroke.
Many patients who suffer a hemorrhagic stroke experience some loss in function, even with treatment. At Penn, neurorehabilitation starts while you are still in the hospital and continues for as long as you need.
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