"Picket Fence" clipping technique for large and complex aneurysms
Document Type
Article
Abstract
The "picket fence" clipping technique is a method for clipping large aneurysms when conventional clipping across the neck is not feasible, either due to complex anatomy, atherosclerosis, calcification, or compromise of branch origins. This has also been described as a dome fenestration tube. Parallel straight clips, simple and/or fenestrated, are stacked vertically from dome to neck with the tips reconstructing the neck. In this video, the "picket fence" clipping technique is demonstrated on a large middle cerebral artery (MCA) aneurysm. A total of 14 clips reconstructed the neck, completely occluding the aneurysm and preserving outflow in all branch vessels. The video can be found here: http://youtu.be/0N5rYR6Op8Y.
Medical Subject Headings
Aneurysm (surgery); Humans; Microsurgery (instrumentation, methods); Neurosurgical Procedures (instrumentation, methods); Surgical Instruments; Treatment Outcome
Publication Date
7-2-2015
Publication Title
Neurosurgical focus
E-ISSN
1092-0684
Volume
39 Video Suppl 1
First Page
V17
PubMed ID
26132615
Digital Object Identifier (DOI)
10.3171/2015.7.FocusVid.14632
Recommended Citation
Davies, Jason M. and Lawton, Michael T., ""Picket Fence" clipping technique for large and complex aneurysms" (2015). Neurosurgery. 1126.
https://scholar.barrowneuro.org/neurosurgery/1126