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Microvascular Clipping

Definition

Microvascular clipping is surgery to cut off blood flow to a brain aneurysm. This is done to try to stop bleeding and rupture. This is an open surgery.

Reasons for Procedure

This surgery is to prevent a brain aneurysm from causing more harm. It will not fix damaged areas of the brain. But, it can improve quality of life by stopping bleeding.
Brain Aneurysm
IMAGE
An aneurysm is a weakened blood vessel in the brain that collects blood. The bulging, blood-filled pocket can put pressure on parts of the brain, pressing on nearby nerves. This can cause symptoms or cause the blood vessel to rupture (hemorrhage).
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Possible Complications

Problems are rare, but all procedures have some risk. Your doctor will talk about possible problems such as:
  • Problems from anesthesia
  • Infection
  • Blood clots
  • Damage to other organs or structures
  • Stroke
  • Seizures
Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:
  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery

Anesthesia

The doctor will give you general anesthesia. You will be asleep.

Description of the Procedure

Hair on the head will be cut at the site.
A small section of the skull will be removed to get to the brain. Imaging tools are used to find the blood vessel. The aneurysm will be removed. A clip will be placed to clamp the artery. The clip will stay in place to prevent bleeding and rupture in the future.
The skull will be returned and secured with plates and screws. The scalp will be stitched back into place. A bandage will be placed over the area.

How Long Will It Take?

3 to 5 hours or longer

Will It Hurt?

Pain is common the first few weeks. Medicine and home care will help.

Average Hospital Stay

The usual length of stay is 4 to 6 days. If there are any problems, you may need to stay longer.

Post-procedure Care

At the Hospital
Right after the procedure, the staff may give you pain medicine.
During your stay, the healthcare staff will take steps to lower your risk of infection such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered.
There are also steps you can take to lower your risk of infection such as:
  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incision
At Home
It may take about 3 to 6 weeks to recover. Physical activity may be limited during this time. Physical therapy may be needed.

Call Your Doctor

Call your doctor if you have:
  • Fever or chills
  • Redness, swelling, excess bleeding, or discharge from the incision site
  • Lasting nausea or vomiting
  • Pain that you cannot control with the medicines
  • Problems with thinking, balance, or movement
  • Weakness, numbness, or tingling
  • Headaches, fainting, vision problems, or problems passing urine or stool (poop)
  • Pain, swelling, or cramping in your legs
Call for medical help right away for:
  • Seizures
  • Problems breathing
  • Chest pain
If you think you have an emergency, call for medical help right away.

RESOURCES

Brain Aneurysm Foundation
https://www.bafound.org
National Institute of Neurological Disorders and Stroke
https://www.ninds.nih.gov

CANADIAN RESOURCES

Brain Injury Canada
https://www.braininjurycanada.ca
Heart and Stroke Foundation
http://www.heartandstroke.ca

References

Cerebral aneurysm. American Association of Neurological Surgeons website. Available at: http://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Cerebral-Aneurysm. Accessed September 3, 2021.
Cerebral aneurysms fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Cerebral-Aneurysms-Fact-Sheet. Accessed September 3, 2021.
Rinkel GJE. Management of patients with unruptured intracranial aneurysms. Curr Opin Neurol. 2019;32(1):49-53.
Subarachnoid hemorrhage. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/subarachnoid-hemorrhage. Accessed September 3, 2021.
Treatment of brain aneurysm. The Aneurysm and AVM Foundation website. Available at: https://www.taafonline.org/conditions/aneurysm/treatment . Accessed September 3, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
  • Review Date: 07/2021
  • Update Date: 09/03/2021