Deanna M. Neff, MPH
Microvascular clipping is a surgery to cut off blood flow to a cerebral
aneurysm. This prevents bleeding and rupture. Typically, a portion of the skull is removed (a procedure called a
craniotomy) and restored during this complex, open surgery.
Microvascular clipping prevents a
brain aneurysm from causing more damage. It will not fix already damaged areas of the brain, but it can improve quality of life by stopping bleeding or preventing rupture.
Problems may occur from the procedure. Your doctor will review potential problems, like:
Factors that may increase the risk of complications include:
Discuss these risks with your doctor before surgery.
Your appointment before the surgery may include:
Women should let their doctor know if they are pregnant or planning to become pregnant.
Before your procedure:
will be used. It will block any pain and keep you asleep through the surgery.
In the operating room, the nurses and doctors will connect you to monitors to watch your blood pressure, heart rate, and pulse. A catheter will be inserted to collect urine during surgery. An IV will be placed in your arm for sedation and anesthesia. The nurse will cut the hair off an area of your head for surgery.
A craniotomy will be performed, removing a small section of the skull to access the brain. X-rays and microscopic viewing may help locate the exact weakened area of the blood vessel. The aneurysm will be separated from nearby healthy brain tissue. A titanium clip will be placed to clamp off the entire artery to the aneurysm to isolate it from general circulation. The clip will stay in place to permanently prevent bleeding and/or rupture.
The section of skull will be replaced, and the scalp will be stitched back into place.
When the procedure is done, the catheter and IV line will be removed. You will need to lie still for 6-8 hours or more. You will stay in the ICU for about a day. Your blood pressure and other vitals will be monitored closely. You may be given medication for pain or other symptoms.
3-5 hours or more
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The surgery is done in a hospital setting. The usual length of stay is 4-6 days. Your doctor may choose to keep you longer if complications arise.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
When you get home, you may have to adjust your activity level while you recover. This may take 3-6 weeks. Home care may include:
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
Call for emergency medical services right away if any of the following occurs:
If you think you have an emergency, call for medical help right away.
The Brain Aneurysm Foundation
National Institute of Neurological Disorders and Stroke
Brain Injury Association of Canada
Heart and Stroke Foundation Canada
Cerebral aneurysm. American Association of Neurological Surgeons website. Available at:
http://www.aans.org/en/Patient%20Information/Conditions%20and%20Treatments/Cerebral%20Aneurysm.aspx. Updated March 2015. Accessed May 10, 2016.
NINDS cerebral aneurysm information page. National Institute of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/disorders/cerebral_aneurysm/cerebral_aneurysms.htm. Updated February 23, 2015. Accessed May 10, 2016.
Subarachnoid hemorrhage.EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 31, 2015. Accessed May 10, 2016.
Treatment of brain aneurysms. The Aneurysm and AVM Foundation website. Available at:
http://www.taafonline.org/ba_treatment.html#ba_clipping. Accessed May 10, 2016.
Williams LN, Brown RD Jr. Management of unruptured aneurysms. Neurol Clin Pract. 2013;3(2):99-108.
Last reviewed June 2016 by Michael Woods, MD
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