Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Clips”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 703 records · Page 39Linked to original sources
PubMed1991

Clipping of an aneurysm 20 years after encasement with methyl methacrylate. Case report.

A variety of agents have been used to coat aneurysms as an alternative to clipping. These agents were employed more frequently prior to the routine use of the operating microscope and the presently available variety of aneurysm clips. One such coating agent is methyl methacrylate. This report describes a patient with an anterior communicating aneurysm that rebled 20 years after being encased in methyl methacrylate. At operation, the pulsating aneurysm had eroded the adjacent layer of methyl methacrylate, creating a small intervening space. This space allowed removal under the microscope (with a high-speed air drill and a diamond bit) of the methyl methacrylate from the anterior cerebral arteries and aneurysm, exposing it for definitive clip placement. The feasibility of clipping encased aneurysms is discussed.

Colloids↗
PubMed1994

Multiple clipping technique for large and giant internal carotid artery aneurysms and complications: angiographic analysis.

Experience with surgical clipping of 16 large and nine giant aneurysms of the intradural internal carotid artery (ICA) is described. Reconstruction of the parent artery with part of the aneurysmal wall was necessary in the majority of cases. Multiple clips were required for satisfactory clipping in 20 cases. Complications related to the clipping procedure comprised occlusion and stenosis of the parent carotid artery in isolated cases. Straightening of the parent carotid artery with consequent kinking of the middle cerebral artery was seen in three cases of an aneurysm with a dome directed ventrally in the proximal segment of the ICA. The factors that caused straightening of the ICA are analyzed. It was observed that an excessive change in the direction of the ICA can cause cerebral infarction.

Aged↗
PubMed1994

Right-angle partially compressible hemostatic clip applier.

A modification of a hemostatic clip applier is described that can apply clips at right angles to the plane of the handles. This device may be particularly useful in certain neurosurgical settings where use of the conventional clip applier is difficult. This device also prevents overcompression of clips.

Dura Mater↗
PubMed2000

Hydrocephalus: comparison of clipping and embolization in aneurysm treatment.

OBJECT: In this retrospective study conducted at Atkinson Morley's Hospital and Middlesbrough General Hospital, the authors analyzed 100 matched patients who had suffered subarachnoid hemorrhage (SAH) to determine whether the technical procedure by which aneurysms are treated affects the development of chronic hydrocephalus. METHODS: Four hundred seventy-five patients presented with SAH between 1995 and 1998. Exclusion criteria included posterior circulation aneurysms, multiple aneurysms, electively clipped or embolized aneurysms, angiographically undetected SAH, patients who died within 1 month of neurosurgical intervention, and patients with the same aneurysm location but a different Fisher grade. The authors matched 50 patients who underwent embolization of their aneurysms with another 50 who had similar Fisher grades and aneurysm types and underwent clipping of their aneurysms. The maximum incidence of ruptured aneurysms occurred in patients who were between 41 and 60 years of age, with women preponderant in both study groups. In each group, 27 patients had anterior communicating artery aneurysm, 13 had posterior communicating artery aneurysm, seven had middle cerebral artery aneurysm, and three had internal carotid artery aneurysm. The lesions in three patients in each group were Fisher Grade I, in 23 patients they were Fisher Grade II, in 14 they were Fisher Grade III, and 10 patients had Fisher Grade IV SAH. Nine patients among those with clipped aneurysms and eight of the patients who underwent embolization had hydrocephalus for which they needed intervention. These interventions included lumbar puncture, ventricular drainage, and ventriculoperitoneal (VP) shunt placement; three patients in each group needed VP shunt placement. CONCLUSIONS: The technical procedure used to treat aneurysms, whether clipping or embolization, does not significantly affect the development of chronic hydrocephalus. However, a larger sample of patients is needed for accurate comparisons and stronger conclusions.

Adolescent↗
PubMed2000

Origin of the Drake fenestrated aneurysm clip.

The development of the Drake fenestrated aneurysm clip is a study in the history of ideas. This communication outlines the conception and solution of a surgical problem involved with the clipping of large basilar tip aneurysms. Dr. Charles G. Drake's ability to modify old ideas and experiment with new ones was instrumental to the conceptual idea of a fenestrated clip. Dr. Frank H. Mayfield and Mr. George Kees, Jr. played essential roles in bringing the idea to a reality. The development of the fenestrated clip has added substantially to the armamentarium of the aneurysm surgeon in dealing with large and complex aneurysms.

Canada↗
PubMed2000

Intraoperative endovascular treatment as an adjunct to microsurgical clipping of paraclinoid aneurysms.

OBJECT: The endovascular procedure can provide proximal control, suction decompression, and prompt intraoperative angiography during microsurgical clipping of aneurysms of the paraclinoid segment of the internal carotid artery (ICA). The authors assess the safety and feasibility of this method in 24 consecutive cases. METHODS: Frontotemporal craniotomy and radical pterionectomy were performed with the patient's head immobilized in a radiolucent frame while femoral artery catheterization was achieved. Before dural opening, a balloon catheter with a coaxial lumen was positioned and tested in the ICA, after which microsurgical exposure was completed, including intradural clinoid drilling and optic canal decompression. Trapping of the lesion was achieved by inflating the balloon and placing a temporary clip beyond the aneurysm neck. The catheter was gently aspirated to achieve suction decompression and to facilitate clip application. Intraoperative digital subtraction angiography was then performed. Twenty-two aneurysms were larger than 10 mm, and 11 of them were giant. Six patients presented with subarachnoid hemorrhage and nine with visual symptoms. Balloon occlusion and suction decompression were performed in 16 cases (67%), and proximal control alone in 1 case. Intraoperative angiography was performed in every case. Subsequent clip readjustment was necessary in seven cases, including three cases of residual aneurysm filling and four of ICA compromise. Complete aneurysm obliteration was achieved in 20 cases, and greater than 90% obliteration in 22. One major infarct likely related to catheter thromboembolism was found. There were no instances of visual deterioration or other complications attributable to the endovascular procedure. CONCLUSIONS: The endovascular method allows safe and reliable proximal control, suction decompression, and intraoperative angiography in microsurgical treatment of large paraclinoid aneurysms.

Aged↗
PubMed2002

Ipsilateral hyperperfusion after neck clipping of a giant internal carotid artery aneurysm. Case report.

A 48-year-old woman exhibited hyperperfusion soon after undergoing a successful clip operation involving multiple clip placement for a giant internal carotid artery (ICA) aneurysm. Intraarterial digital subtraction angiography demonstrated a left paraclinoid giant aneurysm. Multiple clips were placed to obliterate the aneurysm during a 7-minute temporary ICA occlusion. Intraoperative Doppler ultrasound flowmetry showed that the blood flow through the ICA distal to the aneurysm increased from 71.6 ml/minute before clipping to 123.3 ml/minute after. The patient exhibited right hemiparesis and motor aphasia after the operation. Postoperative imaging studies revealed an increase in perfusion and diffuse edema in the left cerebral cortex. The symptoms and diffuse brain edema gradually resolved. In this case, increase in blood flow through the ICA distal to the aneurysm may have played an important role in the circulatory disturbance.

Carotid Artery Diseases↗
PubMed2003

Aneurysm clips.

This communication outlines the development of aneurysm clips, from those originally used by Walter Dandy to those in use today. The history is rich, with many contributions from neurosurgical pioneers and innovators. As a result, the modern neurosurgeon has a wide selection of biocompatible aneurysm clips from which to choose, clips that have known closing pressures and various sizes and shapes, as well as a selection of clip applicators that do not obstruct the surgical field.

Aneurysm↗
PubMed2006

Treatment of ruptured intracranial aneurysms since the International Subarachnoid Aneurysm Trial: practice utilizing clip ligation and coil embolization as individual or complementary therapies.

OBJECT: The aim of this study was to analyze the therapeutic decision-making process and outcome in 100 consecutive patients with aneurysmal subarachnoid hemorrhage (SAH) treated since the completion of the International Subarachnoid Aneurysm Trial (ISAT). All patients were evaluated and treated by a neurosurgeon with subspecialty training in both cerebrovascular and neuroendovascular surgery. METHODS: One hundred consecutive patients with aneurysmal SAH who had been admitted within 1 week posthemorrhage and who had been treated using either surgical clip application or endovascular coil embolization were included in this analysis. All patients underwent a uniform perioperative protocol. All surviving patients were given a questionnaire to assess their modified Rankin Scale score (mRS) and to grade themselves at 6 months and 1 year postintervention. The cohort consisted of 73 women and 27 men with a mean age of 57.27 years (range 27-87 years). Twenty-nine percent of the patients had a World Federation of Neurosurgical Societies (WFNS) Grade IV or V SAH. Forty-seven patients underwent direct surgical clip application, 41 endovascular embolization, and 12 a combination of the two procedures. Good functional outcome--indicated by mRS scores of 0 to 2 after at least 6 months--was achieved in 71% of patients. CONCLUSIONS: Data from the ISAT demonstrated a better functional outcome following endovascular embolization in a selected group of patients with aneurysmal SAH. In routine clinical practice, however, a significant number of patients still benefit from direct surgical clip ligation. Excellent functional results can be realized in a complementary clip ligation and coil occlusion practice in which each patient and aneurysm is evaluated and the two treatment modalities are used individually or, when needed, in combination.

Adult↗
PubMed1991

High salt intake attenuates the development of hypertension in two-kidney, one-clip Goldblatt rats.

Effects of high salt intake on the early onset of hypertension were examined in two-kidney, one-clip rats. They were divided into high salt and control groups which were supplied with 1.0% NaCl and tap water, respectively, as a drinking solution for 12 days after clipping the left renal artery. The high salt group showed a lower plasma renin concentration and a higher plasma atrial natriuretic peptide (ANP) along with an attenuation of the magnitude of early hypertension, as compared with the control group. A significant positive correlation between blood pressure and plasma renin concentration and an inverse correlation between plasma renin concentration and ANP were shown. Cortical renal renin content was comparable between the two groups. In another two groups of sham-clipped rats, the high salt group did not differ from the tap water-drinking group in any of the parameters examined, except that ANP was significantly higher. These results demonstrate that high salt intake attenuates the developmental phase of hypertension in two-kidney, one-clip rats by increasing the ANP and suppressing the release of renin.

Animals↗
PubMed1992

Influence of increasing photoperiod and toe clipping on breast buttons of turkeys.

Two 17-wk experiments compared the effects of an increasing photoperiod treatment (INC) versus a constant photoperiod treatment (23H), and intact toes versus clipped toes, on the breast button incidence and performance of heavy tom turkeys. Under INC, the photoperiod was increased gradually from 8 to 23 h between 4 and 16 wk. Under 23H, the photoperiod remained constant at 23 h. Use of INC versus 23H resulted in a significant reduction in breast button incidence at 17 wk in both experiments (P less than .05). Toe clipping had no effect on breast button incidence. The presence of breast buttons was positively correlated with body weight at 12 wk, and area of unfeathered skin over the keel at 17 wk. In Experiment 1, the photoperiod treatments had no significant effect on 17-wk body weight or mortality, but the INC treatment had an adverse effect on feed efficiency (P less than .05). In Experiment 2, turkeys reared under INC were heavier at 17 wk (P less than .05), with similar feed efficiencies. Mortality was significantly lower on INC than 23H up to 12 wk in Experiment 2 (P less than .05). Turkeys with intact toes were .44 kg heavier than turkeys with clipped toes at 17 wk in both experiments (P less than .05) and had similar feed efficiencies. Mortality to 4 wk was lower for turkeys with intact than clipped toes in Experiment 2 (P less than .05). Increasing photoperiod treatments have potential for improving turkey performance, survival, and carcass quality.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1999

Prognostic meaning of temporary clipping in patients with intracranial aneurysm.

The prognostic meaning of the routine use of the methods of temporary clipping of the afferent vessel in patients with intracranial aneurysm (Grading 0-III) was the aim of the analysis in this study. In the period 1 January, 1991-31 December 1997, 304 patients underwent surgery for non-giant intracranial aneurysm and a follow-up angiography. 157 patients were operated by routinely using the temporary clipping of the afferent vessel, whereas in 147 patients the surgical procedure was performed by traditional methods. The statistical analysis showed a significant reduction (p < 0.001) in terms of risk of surgical complications in the patients who underwent surgery with the temporary clip method compared to those operated with the traditional method, with a relative risk of such complications about three times greater in the latter. The routine use of temporary clipping offers, therefore, the possibility of a significant improvement of the surgical results, not influenced by a further involvement for the structure, due to the short application time.

Aneurysm, Ruptured↗
PubMed2000

Analysis of morphine by RIA and HPLC in fingernail clippings obtained from heroin users.

Heroin is abused around the world and is frequently reported as the cause of death in overdose cases. Analysis of morphine in hair has been used in the past in forensic toxicology to study the addiction history of heroin addicts. The purpose of the present study was to evaluate the usefulness of the nail as an analytical specimen in the identification and quantification of morphine in fingernail clippings of known heroin users. Fingernail clippings were obtained from 26 consenting patients of the Glasgow Drug Problem Service. At the time of sampling, the participants provided answers to a questionnaire regarding their drug use patterns. Samples were decontaminated by sonication in SDS, deionized water and methanol, and the methanolic washes were screened for analyte presence. The washed nail clippings were then hydrolyzed and extracted. RIA was used for the screening and HPLC for the confirmation of morphine. Positive RIA results were obtained with nail clippings from 25 of the 26 heroin users. The levels ranged from 0.06 to 4.69 ng/mg with a mean morphine concentration of 1.67 ng/mg. HPLC results were positive for 22 of the 26 nail samples. The mean morphine level by HPLC was 2.11 ng/mg with a range from 0.14 to 6.90 ng/mg. Based on these results, we suggest that nails have the potential of becoming a powerful alternative to hair for the detection of past heroin use in forensic cases.

Adult↗
PubMed2001

[Laparoscopic sterilization using the Filshie clip--a prospective study of 180 patients].

OBJECTIVE: In this prospective study from 1997-2000, authors have been analyzing preliminary results of 180 tubal sterilizations, which were performed by method of the laparoscopic application of Filshie clips. DESIGN: Prospective study. SETTING: Department of operative gynaecology and minimally invasive surgery, Hospital Na Homolce, Prague. METHODS: The procedures were performed in accordance with the still valid Public Notice of the Czech Republic Ministry of Health n. 1/1972, section 5/1972. The mean age of the patients was 38.6 years, with each patient having 2.1 living children on average. During the intervention 42% of the patients either had IUD or were taking a hormonal contraceptive, while 29% of the patients had in their history a record of previous abdominal surgery. RESULTS: The average duration of the operation (from the incision to the closure) was 14 min. There were no per- or postoperative complications and until the present we have no knowledge of failure. In the view of both the patient and the surgeon, this is the most acceptable procedure. CONCLUSION: In accordance with the British (RCOG) and the Canadian Gynecological Society conclusions and also on the basis of many randomized studies and recommendations from WHO, we conclude that the laparoscopic approach with the mechanical tubal occlusion by means of the clip is the first choice method. Our previous experience and meta-analytic studies of the literature, demonstrate that from all accessible clip methods, the Filshie clip method is the most suitable as it has the lowest failure rate, the least occurrences of extrauterine gravidity (in a case of failure). Most importantly it is a simple, quick and easily taught method. Another potentially significant factor is the highest rate of successful reversibility.

Female↗
PubMed2001

[Comparative study of microvascular anastomotic clips and suture in small vessel anastomosis].

OBJECTIVE: To explore an ideal way of small vessel anastomosis for microsurgery. METHODS: Anastomosis of both carotid arteries were performed in 20 rabbits. One side of the arteries were anastomosed with anastomotic clips, the other side of the arteries, as comparison, were anastomosed with suture. The vessels were harvested at first and 14th day after operation and were evaluated using operating microscope, light microscope and electronic microscope. RESULTS: The average anastomotic time for suture was about 15 minutes, while for the clips was 2 to 5 minutes. There were no difference in patency between the two techniques. Endothelialization at the anastomotic sites were both completed 14 days postoperatively. However, for the anastomotic clips, there were no endothelia damage and foreign bodies formation inside the vessels. CONCLUSION: This experiment has confirmed that the anastomotic clip's procedure provides a very safe and easy way to perform anastomosis and reduce the incidence of thromboses.

Anastomosis, Surgical↗
PubMed2000

[Pot experiment on effect of clipping at seedling stage on spring wheat].

Pot experiment on the compensatory effects of spring wheat(Triticum aestivum) at different clipping intensities (simulating herbivory) at seedling stage (three leaves) was conducted in semiarid region of Gansu Province. Under two conditions of 60% and 90% of field water-holding capacity, spring wheat growth was stimulated by clipping at seedling stage, resulting in overcompensation in biological and economic yields, and with more compensation for heavy clipping than light clipping. The overcompensation of the spring wheat was at the cost of more water consumption.

Plant Development↗
PubMed2001

[Intentional neck-plastic incomplete clipping followed by coil embolization for broad-necked distal BA aneurysms].

OBJECTIVE: We report three patients with broad-necked distal basilar artery (BA) aneurysms treated with intentional incomplete clipping followed by endovascular occlusion using Guglielmi detachable coils. METHODS: The location of the aneurysms was BA bifurcation in one patient and BA-superior cerebellar artery (SCA) in two. One patient presented with acute subarachnoid hemorrhage and two patients had incidental aneurysms. In two patients, endovascular treatment was thought to be difficult considering the morphology of the aneurysms and surgical treatment was performed as the first choice of treatment. One patient with a BA-SCA aneurysm underwent endovascular treatment using a remodelling technique first. However, it was impossible to place the coil preserving SCA, so surgical treatment was performed. In all patients, the attempt to pursue complete clipping was considered to be accompanied with high risks of morbidity, so neck-plastic incomplete clipping was performed intentionally. One to six days after the surgery, coil embolization was performed. RESULTS: In all patients, complete occlusion of the aneurysms was achieved and all patients had excellent clinical outcomes. CONCLUSION: Intentional neck-plastic incomplete clipping followed by endovascular coiling may be a useful treatment option for patients with broad-necked distal BA aneurysms.

Aged↗
PubMed1999

[Complete overdenture retained with implants and bar-clip attachments].

OBJECTIVE: To sum up and evaluate the applied experience and applied effects of implants and bar-clip attachments in complete overdenture. METHODS: Bar-clip attachments were used as a super structure of implant to manufacture complete overdenture in three designs: mucosa, implant-mucosa, and implant supporting way. The retentive force of the overdenture was measured with measuring instrument of retentive force of prosthesis. RESULTS: All three designs could obtain good retentive effect, specially implant-mucosa supporting and implant supporting designs, which were of more better stability and supporting effect; 2-3 nelon clips could supply 10-15 N retentive force to the overdenture. CONCLUSION: The complete overdenture retained with implant and bar-clips attachments is a very effective way for restoration of endtulous patients, which should be applied more popularly.

Dental Implants↗