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Dr. Achal GuptaNeuron Brain & Spine Centre
Vascular NeurosurgeryNeurosurgery

Microsurgical Aneurysm Clipping & Vascular Repair

Microsurgical clipping remains the gold standard definitive curative treatment for many cerebral aneurysms. Under high magnification, the neurosurgeon navigates natural brain fissures to place a micro-titanium clip across the aneurysm neck, permanently sealing it from circulation.

Microsurgical Aneurysm Clipping & Vascular Repair
Surgical Technique

How This Technique Works

Using micro-dissection instruments and indocyanine green (ICG) videoangiography, the aneurysm is separated from adjacent perforating arteries. A titanium clip with calibrated spring tension is applied across the base, maintaining uninterrupted blood flow through the parent vessel.

Key Potential Advantages

Extremely durable, permanent seal with lowest long-term recurrence rates
Elimination of mass effect on adjacent cranial nerves
Immediate intraoperative visual and angiographic confirmation of obliteration
Procedure Steps

Step-by-Step Surgical Workflow

A methodical operative sequence prioritizing anatomical visualization, sub-millimeter precision, and minimal tissue disruption.

Step 01

Pterional or Keyhole Craniotomy

Microsurgical skull opening tailored to access the Circle of Willis.

Step 02

Sylvian Fissure Dissection

Gentle splitting of natural anatomical fissures without brain retraction.

Step 03

Aneurysm Neck Isolation

Delineation of the aneurysm dome, neck, and surrounding vital perforators.

Step 04

Micro-Clip Placement

Application of a permanent MRI-compatible titanium clip across the aneurysm neck.

Step 05

ICG Fluorescence Angiography

Real-time intraoperative infrared confirmation of complete aneurysm obliteration and patent parent arteries.

Clinical Candidacy

Patient Selection & Considerations

Optimal outcomes depend on careful patient selection, precise imaging correlation, and realistic recovery expectations.

Who May Be Considered?

  • Ruptured or unruptured cerebral aneurysms with favorable microsurgical morphology (e.g., middle cerebral artery MCA, wide-necked aneurysms)
  • Arteriovenous malformations (AVMs) and cavernous malformations

When It May Not Be Appropriate

  • Lesions more safely addressed by endovascular coiling or flow diversion based on vascular anatomy
Post-Operative Pathway

Recovery Milestones

A structured timeline designed to safely restore function and support long-term wellness.

Acute Post-op

Neuro-ICU hemodynamic monitoring and vascular surveillance.

Months 1-3

Gradual resumption of normal daily routines and routine vascular imaging follow-up.

Procedure FAQs

Questions About Vascular Neurosurgery

Yes, modern aneurysm clips are crafted from high-grade titanium alloys that are non-ferromagnetic and completely MRI-safe.
Neuron Brain & Spine Centre • Gomti Nagar, Lucknow

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Neuron Brain & Spine CentreB-2/1, Vibhuti Khand, Gomti Nagar, Lucknow
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