"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

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