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The The art of cerebral aneurysm clippology in clip limited setting: A literature review and a perspective experiences in Indonesia

  • Mardjono Tjahjadi ,
  • Yemima Graciela ,
  • Robert Shen ,

Abstract

Introduction: Microsurgical clipping for cerebral aneurysms is still the mainstay therapy in developing countries because of its superiority in cost-effectivity and durability to control unruptured cerebral aneurysms in reducing residual and recurrence rates by complete total occlusion achieved compared to coiling. However, neurosurgical facilities in Indonesia frequently encounter the challenge of limited clip availability in size and shape variations, besides the problems of limited qualified cerebrovascular experts to perform the microsurgical clipping. Furthermore, unprecise and inefficient closure of the aneurysm's neck due to inadequate clipping could lead to residual and rebleeding.

Methods: A literature review was conducted in this study along with the authors’ perspective experiences working in a clip-limited setting hospital to achieve effective aneurysm occlusion.

Literature Review: A brief introduction to clipping history, biomechanicals, types, physics, and utilization of temporary and permanent clipping are required for this limited clip-selection facility, especially for young neurosurgeons. Regarding the limited size and shape of aneurysm clips, several clipping methods can be used alternatively to achieve a good clinical outcome and total aneurysm occlusion.

Conclusion: As most neurosurgery centers in Indonesia face limited clip-selection settings, continuous experience sharing and better knowledge must be improved.

Keywords: aneurysm clipping, cerebral aneurysm, clippology, microneurosurgery

How to Cite

Tjahjadi, M., Graciela, Y., & Shen, R. (2023). The The art of cerebral aneurysm clippology in clip limited setting: A literature review and a perspective experiences in Indonesia. Indonesian Journal of Neurosurgery, 6(3), 55–59. https://doi.org/10.15562/ijn.v6i3.249

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