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Microvascular Clipping

Authors:
  • Amy Scholten, MPH
Publication Type:

Procedure

Microvascular Clipping

Definition

Microvascular clipping is surgery to cut off blood flow to a brain aneurysm. This is done to try to stop bleeding and rupture. This is an open surgery.

Reasons for Procedure

This surgery is to prevent a brain aneurysm from causing more harm. It will not fix damaged areas of the brain. It can help with quality of life by stopping bleeding.

Brain Aneurysm.

An aneurysm is a weakened blood vessel in the brain that collects blood. The bulging, blood-filled pocket can put pressure on parts of the brain, pressing on nearby nerves. This can cause symptoms or cause the blood vessel to rupture (hemorrhage).

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Possible Complications

Problems are rare, but all procedures have some risk. Your doctor will go over possible problems such as:

  • Problems from anesthesia
  • Infection
  • Blood clots
  • Damage to other organs or structures
  • Stroke
  • Seizures

Things that may raise the risk of problems are:

What to Expect

Problems To Look Out For

Call your doctor if you have:

  • Fever or chills
  • Redness, swelling, excess bleeding, or discharge from the incision site
  • Lasting nausea or vomiting
  • Pain that you cannot control with the medicines given
  • Problems with thinking, balance, or movement
  • Weakness, numbness, or tingling
  • Headaches, fainting, vision problems, or problems passing urine or stool (poop)
  • Pain, swelling, or cramping in your legs

Call for medical help right away for:

  • Seizures
  • Problems breathing
  • Chest pain

If you think you have an emergency, call for medical help right away.

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery

Anesthesia

The doctor will give you general anesthesia. You will be asleep.

Description of the Procedure

Hair on the head will be cut at the site.

A small section of the skull will be removed to get to the brain. Imaging tools are used to find the blood vessel. The aneurysm will be removed. A clip will be placed to clamp the artery. The clip will stay in place to stop bleeding and rupture in the future.

The skull will be returned and secured with plates and screws. The scalp will be stitched back into place. A bandage will be placed over the area.

How Long Will It Take?

3 to 5 hours or longer

Will It Hurt?

Pain is common for the first few weeks. Medicine and home care will help.

Average Hospital Stay

The usual length of stay is 4 to 6 days. People may need to stay longer if there are any problems.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may give you pain medicine.

During your stay, the staff will take steps to lower your risk of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered.

There are also steps you can take to lower your risk of infection such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incision

At Home

It may take about 3 to 6 weeks to recover. Physical activity may be limited during this time. Physical therapy may be needed.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Cerebral aneurysm. American Association of Neurological Surgeons website. Available at: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Cerebral-Aneurysm.
  • Cerebral aneurysms fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/cerebral-aneurysms-fact-sheet.
  • Rinkel, G.J.E. Management of patients with unruptured intracranial aneurysms. Curr Opin Neurol, 2019; 32 (1): 49-53.
  • Subarachnoid hemorrhage. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/subarachnoid-hemorrhage.
  • Treatment of brain aneurysm. The Aneurysm and AVM Foundation website. Available at: https://www.taafonline.org/conditions/aneurysm/treatment.

Contributors

  • Nicole Meregian, PA
Last Updated:
2022-11-01

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.