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Year : 2021  |  Volume : 7  |  Issue : 3  |  Page : 207-210

Mechanical clot dissolution technique for surgical clip-related occlusions: An emergent triple-step approach

Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Chirag Jain
21, Aradhana, Sector-13, RK Puram, New Delhi - 110 066
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/bc.bc_58_20

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Cerebral ischemia following clipping of cerebral aneurysms constitutes major cause of morbidity and mortality. Clip-related injury to vessel, postoperative clip rotation, prolonged temporary occlusion, intraoperative rupture, and vasospasm are some etiological factors compromising forward flow in parent or branch vessel. On suspicion of compromised forward flow, immediate intraoperative evaluation is done to detect the cause of vascular compromise and further management is done by microsurgical or endovascular means. We describe a case of ruptured distal anterior cerebral artery (ACA) aneurysm complicated by occlusion of ACA after surgical clipping. The patient was managed by endovascular means by combined technique of intra-arterial nimodipine, antiplatelet infusion, and mechanical clot disruption using J-tip microwire.

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