Late postoperative slippage of the cerebral aneurysm clip. A systematic review and meta-analysis
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Background A late clip slippage from the previously properly secured cerebral aneurysm is rarely observed. To date these complications have not pooled and evaluated using systematic review methodology. The objective was to report factors attributed to the late slippage of the aneurysm clip in the postoperative period. Material and methods All causes of postoperative clip slippage were systematically reviewed and analysed according to PRISMA Individual Patient Data protocol. Medline (PubMed), Embase, Cochrane, ISI Web of Knowledge and Google Scholar were searched for all relevant cases. Results Systematic review of the literature yielded 105 original cases proving slipped clip in the postoperative period. The slipped clip caused bleeding in 53.8% of patients. The putative cause of clip slippage was provided in only 34.7% of the published cases. If a single clip was used, then complete clip slippage was noted more often (p=0.04). Multiple clipping and clip-wrapping techniques were postulated as ways to prevent postoperative clip slippage. Conclusions The reason for late slippage of the aneurysm clip remains unexplained by most authors. Based on systematic reviewing, the use of tandem of clips prevents their late migration off the aneurysm. Clipping with wrapping or use of a single clip reinforced by any wrapping material seems a more durable solution.
- Drake CG, Peerless SJ, Hernesniemi JA. Surgery of Vertebrobasilar Aneurysms [Internet]. Vienna: Springer Vienna; 1996. Available from: http://link.springer.com/10.1007/978-3-7091-9409-6.
- Giannotta SL. Complication A voidance for Large and Giant Carotid Ophthalmic Aneurysms. In. New Trends in Management of Cerebro-Vascular Malformations [Internet]. Pasqualin A, Da Pian R, editors. Vienna: Springer Vienna; 1994 [cited 2014 Sep 12]. 198-202 p. Available from: http://link.springer.com/10.1007/978-3-7091-9330-3.
- Szmuda T, Słoniewski P. Giant Intracranial Aneurysms - Surgical Treatment, Accessory Techniques and Outcome. In: Murai Y, editor. Aneurysm [Internet]. InTech; 2012 [cited 2014 Sep 5]. p. 351–82. Available from: http://cdn.intechopen.com/pdfs-wm/38617.pdf.
- Carvi y Nievas M, Höllerhage H. Risk of intraoperative aneurysm clip slippage: a new experience with titanium clips. J Neurosurg [Internet]. 2000 Mar [cited 2014 Sep 5];92(3):478–80. Available from: http://thejns.org/doi/abs/10.3171/jns.2000.92.3.0478.
- Carvi y Nievas M. Assessment of the clipping efficacy of intracranial aneurysms: analysis of the employed methodology in relation to case difficulty. Neurol Res [Internet]. 2007 Jul [cited 2014 Sep 3];29(5):506–16. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17535574.
- Horiuchi T, Li Y, Seguchi T, Sato A, Aoyama T, Hanaoka Y, et al. Clip blade scissoring with titanium bayonet clip in aneurysm surgery. Two case reports. Neurol Med Chir (Tokyo) [Internet]. 2012 [cited 2017 Nov 26];52(2):84–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22362289.
- Kariyattil R, Panikar D. Scissoring of a Cobalt Alloy Aneurysm Clip causing Slippage during Cerebral Aneurysm Surgery: Case report and review of literature. Sultan Qaboos Univ Med J [Internet]. 2013 Feb [cited 2014 Sep 2];13(1):179–82. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3616789&tool=pmcentrez&rendertype=abstract.
- Asgari S, Wanke I, Schoch B, Stolke D. Recurrent hemorrhage after initially complete occlusion of intracranial aneurysms. Neurosurg Rev [Internet]. 2003 Oct [cited 2014 Sep 2];26(4):269–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12802695.
- Giannotta SL, Litofsky NS. Reoperative management of intracranial aneurysms. J Neurosurg [Internet]. 1995 Sep [cited 2014 Sep 2];83(3):387–93. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7666212.
- McKissock W. Recurrence of an Intracranial Aneurysm after Excision. J Neurosurg [Internet]. 1965 Nov [cited 2017 Nov 26];23(5):547–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/5858447.
- Kim YH, Kim JE, Kang H-S, Han DH. Migration of an aneurysm clip to the sacral subarachnoid space. Acta Neurochir (Wien) [Internet]. 2009 Mar 10 [cited 2014 Sep 2];151(6):699–700. Available from: http://www.scopus.com/inward/record.url?eid=2-s2.0-67650444427&partnerID=tZOtx3y1.
- Oyesiku NM, Jones RK. Migration of a Heifetz aneurysm clip to the cauda equina causing lumbar radiculopathy. Case report. J Neurosurg [Internet]. 1986 Aug [cited 2014 Sep 5];65(2):256–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2941527.
- Hayashi Y, Kimura M, Satake R, Kinoshita A. Possible participation of clip rotation in the formation of de novo aneurysm. J Clin Neurosci [Internet]. 2004 Apr [cited 2014 Sep 6];11(3):331–4. Available from: http://www.sciencedirect.com/science/article/pii/S0967586803001991.
- Beltagy M El, Muroi C, Roth P, Fandino J, El Beltagy M, Imhof H-G, et al. Recurrent Intracranial Aneurysms After Successful Neck Clipping. World Neurosurg [Internet]. 2010 [cited 2014 Sep 5];74:472–7. Available from: http://www.sciencedirect.com/science/article/pii/S1878875010002846.
- Szmuda T, Słoniewski P. Postoperative cerebral aneurysm clip slippage: systematic review. PROSPERO 2014 CRD42014013843 [Internet]. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=13843.
- Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med [Internet]. 2009 Jul 21 [cited 2014 Mar 20];6(7):e1000097. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2707599&tool=pmcentrez&rendertype=abstract.
- Stewart LA, Clarke M, Rovers M, Riley RD, Simmonds M, Stewart G, et al. Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data: the PRISMA-IPD Statement. JAMA [Internet]. 2015 Apr 28 [cited 2016 Dec 27];313(16):1657–65. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2015.3656.
- Wester K. Lessons learned by personal failures in aneurysm surgery: what went wrong, and why? Acta Neurochir (Wien) [Internet]. 2009 Sep [cited 2014 Sep 3];151(9):1013–24. Available from: http://www.scopus.com/inward/record.url?eid=2-s2.0-69249213985&partnerID=tZOtx3y1.
- Park CK, Shin HS, Choi SK, Lee SH, Koh JS, Martin N. Clinical Analysis and Surgical Considerations of Atherosclerotic Cerebral Aneurysms: Experience of a Single Center. J Cerebrovasc Endovasc Neurosurg [Internet]. 2014 Sep 1 [cited 2017 Jul 10];16(3):247. Available from: https://synapse.koreamed.org/DOIx.php?id=10.7461/jcen.2014.16.3.247.
- Nakamura K, Kitabayashi M, Murata T. Clipping for Wide-necked Asymptomatic Unruptured Intracranial Aneurysm. Surg Cereb Stroke [Internet]. 2012 Mar 19 [cited 2014 Sep 7];40(4):251–6. Available from: https://www.jstage.jst.go.jp/article/scs/40/4/40_251/_article.
- Fujioka S. clipping on wrapping method for treatment of short aneurysms. Surg Cereb Stroke [Internet]. 2003 [cited 2014 Sep 4];31:375–9. Available from: http://jlc.jst.go.jp/JST.JSTAGE/scs/31.375?from=Google.
- Shigeta H, Kyoshima K, Nakagawa F, Kobayashi S. Dorsal internal carotid artery aneurysms with special reference to angiographic presentation and surgical management. Acta Neurochir (Wien). 1992;119(1–4):42–8.
- Yoshimoto Y, Ochiai C, Nagai M. Cerebral aneurysms unrelated to arterial bifurcations. Acta Neurochir (Wien). 1996;138(8):958–63.
- Mooney MA, Kalani MYS, Nakaji P, Albuquerque FC, McDougall CG, Spetzler RF, et al. Long-term Patient Outcomes After Microsurgical Treatment of Blister-Like Aneurysms of the Basilar Artery. Neurosurgery [Internet]. 2015 Sep [cited 2016 Dec 27];11 Suppl 3:387–93. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00006123-201509001-00005.
- Brown MA, Guandique CF, Parish J, McMillan AC, Lehnert S, Mansour N, et al. Long-term follow-up analysis of microsurgical clip ligation and endovascular coil embolization for dorsal wall blister aneurysms of the internal carotid artery. J Clin Neurosci [Internet]. 2017 May [cited 2017 Nov 26];39:72–7. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0967586816309419.
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