Aneurysms Clipping Surgery
At The Brain and Spine Centre, we specialize in the diagnosis and surgical treatment of neurological and spinal disorders. Dr. Muhammad Aqeel Natt, a leading neurosurgeon in Lahore, provides advanced, safe, and compassionate care for patients.
Aneurysms Clipping Surgery
Aneurysm clipping surgery is a microsurgical procedure that places a small metal clip across the neck of a brain aneurysm to prevent blood flow into the sac, reducing rupture risk and securing the lesion permanently. At The Brain and Spine Centre, Dr. Muhammad Aqeel Natt performs aneurysm clipping at Farooq Hospital, West Wood Branch, Lahore, for ruptured and unruptured aneurysms, offering durable treatment preferred for complex anatomy or wide-neck lesions.
Our goal is simple: isolate the aneurysm completely, preserve parent artery patency, and prevent rebleeding or growth with a permanent mechanical solution.
What Is Aneurysm Clipping Surgery?
Aneurysm clipping involves open craniotomy to directly visualise and clip the aneurysm neck using a microscope, titanium clips, and microsurgical dissection; it provides definitive exclusion unlike coiling, which carries retreatment risk. Ideal for anterior circulation aneurysms (ACA, MCA), posterior communicating artery aneurysms, or those unsuitable for endovascular therapy due to shape, location, or perforator involvement.
Symptoms and Indications
Clipping is indicated for:
Ruptured aneurysms causing subarachnoid hemorrhage (SAH).
Unruptured aneurysms >7 mm, symptomatic, or with daughter sacs.
Failed coiling or wide-neck aneurysms.
Diagnosis
CT/CTA/MRA/DSA: aneurysm size, neck width, branch involvement.
Fisher grade for SAH risk stratification.
The Procedure
Performed under general anesthesia with neuromonitoring.
Key steps:
Head fixed; incision behind hairline (pterional, orbitozygomatic, or retrosigmoid based on location).
Craniotomy: bone flap removed to expose dura.
Dural opening; brain relaxed (mannitol, CSF drainage); Sylvian fissure split to expose circle of Willis.
Temporary clip on parent artery if needed; aneurysm dissected from brain/perforators using ball-tip dissector.
Clip applied across neck with applier; multiple clips or fenestrated clips if branches involved; dome punctured to confirm exclusion.
Indocyanine green angiography (ICG) or micro-Doppler verifies patency; bone flap replaced with plates/screws.
Duration: 3-6 hours depending on complexity.
Recovery & Aftercare
Neuro-ICU: 24-72 hours for SAH; monitor vasospasm.
Hospital: 5-7 days; gradual mobilization.
Nimodipine for vasospasm prevention; anticonvulsants if SAH.
Follow-up DSA/MRA at 6 months, 1 year.
Results You Can Expect
Complete occlusion: >95%; rebleeding risk <1% vs 20-50% untreated.
Good outcome (mRS 0-2): 70-90% for unruptured; 50-70% for ruptured SAH.
Risks: stroke (5-10%), infection (2%), clip slippage (<1%).
Why Choose The Brain and Spine Centre
Expertise in complex clipping (e.g., MCA, PCOM, basilar); intraoperative ICG/angiography for verification. 24/7 neuro-ICU for SAH management. Preferred over coiling for permanent occlusion in suitable anatomy.
Cost of Aneurysm Clipping Surgery
Includes craniotomy, ICU, imaging; higher than coiling but durable. Estimates post-DSA.
