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At least 955 records · Page 53Linked to original sources
PubMed1986

[Rapid growth and rupture of a newly originated aneurysm near the clipped middle cerebral artery aneurysm].

A 38-year-old man was admitted to our hospital because of severe headache following reduced level of consciousness on February 13, 1979. He was lethargic and showed neck stiffness. A lumbar puncture revealed bloody cerebrospinal fluid. Left carotid angiography showed a berry aneurysm of 11 mm in diameter at the bifurcation of the middle cerebral artery (MCA). Rebleeding occurred on February 21, and he fell into semicoma. But, his consciousness recovered to lethargy on the next day. On February 26, a direct intracranial operation was performed and a Sugita clip was placed to the aneurysmal neck. The postoperative course was uneventful. But, left carotid angiography on 8th day after operation showed a newly originated aneurysm proximal to the operated aneurysm. On the 12th postoperative day, he suddenly fell into coma. CT showed subarachnoid blood in the basal cisterns and intraparenchymal hematoma in the left temporal lobe. On the same day, left carotid angiography was performed and it showed the enlarged aneurysm. He died on the 19th day after operation. Autopsy was not performed. Three factors have been considered dealing with the recurrence of the operated aneurysm in the previous reports: first, local fragility of the vascular wall due to the clip edge. Secondly, macro- or microscopic residual aneurysmal neck, thirdly, broken or slipped clip. Our case had the following characteristics from the angiographical and operative findings: the orifice of the operated aneurysm was situated on the superior side of the parent artery and the aneurysm protruded posterosuperiorly at an angle of approximately 90 degrees to the long axis of M1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Chronic captopril infusion in two-kidney, one clip rats with normal plasma renin concentration.

Immediately after clipping, plasma renin and angiotensin II concentrations are raised in the two-kidney, one clip rat. Plasma renin and angiotensin II fall to relatively low levels between two and five weeks after operation, while blood pressure continues to rise. An experiment was carried out to determine whether complete suppression of angiotensin II during this two- to five-week period would have any effect on the development of hypertension. Captopril infused chronically (2 mg/kg/h) for up to 20 days completely prevented the rise in mean blood pressure [110.8 +/- 17.9 at day 0 compared to 88.3 +/- 8.4 (s.d.) mmHg at day 20] seen in an equivalent control group infused with dextrose (109.2 +/- 11.6 at day 0 compared to 131.7 +/- 23.6 mmHg at day 20). Preinfusion values for plasma renin and angiotensin II concentration were within the upper half of the range found for sham-operated normal rats. These findings would suggest that while the plasma levels of angiotensin II are low in relation to those seen immediately after clipping, they are still raised in comparison with normal sham-operated rats; this may contribute to the development of hypertension by a slow chronic, rather than an acute, effect.

Angiotensin I↗
PubMed1984

[Experimental study of an absorbable hemostatic clip].

A new absorbable hemostatic clip was investigated by a study in the rat. The reliability and innocuity of the clip were similar to that of the metallic clips from the clinical point of view. Its absorbability and radiotransparency qualities make it the method of choice for ensuring hemostasis and lymphostasis when long-term follow-up investigations involve modern radiological techniques such as computed tomography.

Animals↗
PubMed1984

[Changes in the activity of renal intracortical kallikrein during induction of Goldblatt arterial hypertension of the 2 kidney--1 clip type in the rat].

Renal tissue kallikrein and proteins were measured in two kidney-one clip Goldblatt hypertensive rats both in the stenotic and the controlateral kidney and in sham operated rats at either 1 or 2 weeks after clipping. Activity was assessed by the amidolytic activity and by the kininogenase activity. Kallikrein in normotensive controls was 97.4 +/- 13 ng of bradykinin min-1 mg-1 of protein at week 1 and increased up to 116 +/- 18. Kallikrein in the GH rats was 83 +/- 12 in the stenotic kidney and 85,6 +/- 14 in the controlateral one at week 1, these values remained unchanged at week 2. As a consequence renal tissue kallikrein became significantly lower in the GH rats only at week 2 when compared to controls both the clipped and unclipped kidney showed the same magnitude decrease. Protein concentration remained at a steady level through out the 2 weeks of study. The results suggest that the lower renal kallikrein activity secondary to hypertension found in GH rats result from a decreased activation of prekallikrein in both kidney.

Animals↗
PubMed1984

Magnetic resonance imaging and surgical clips.

Magnetic resonance imaging produces diagnostically useful images of soft-tissue structures within the body. Implanted magnetic materials degrade these images and are subject to magnetic forces from the imaging process. The authors evaluated 54 surgical clips (38 aneurysm and 16 hemostatic) for compatibility with magnetic resonance imaging. From their findings, they recommend that the use of ferromagnetic clips be discontinued and that until this is accomplished, a record of the type of clips used be noted so that the patient is not placed at risk by the use of magnetic resonance imaging or deprived of the diagnostic benefits associated with its use.

Humans↗
PubMed1981

Optic nerve clipping for hemostasis during enucleation.

An instrument is described for sectioning the optic nerve during enucleation that has several advantages over presently used techniques. the instrument applies a nonreactive, tantalum clip around the optic nerve, and a built-in knife blade transects the nerve anterior to the clip. In addition to providing rapid and effective hemostasis of the vessels within and surrounding the optic nerve, the device cuts only tissue that is encompassed by the clip and not extraneous structures.

Hemostasis, Surgical↗
PubMed1980

Aneurysm clip testing meter.

The force that a vascular clip exerts when it is applied to a vessel is a critical factor in its safe and proper use. Permanent occlusion effected in the obliteration of aneurysms requires clip closure forces great enough to resist sliping, yet low enough not to damage the neck of the aneurysm. The authors consider the need for a device that can readily measure clip closing forces just prior to pre-surgical sterilization (immediately prior to implantation), and an instrument that meets that need is presented.

Aneurysm↗
PubMed1995

Combined use of endovascular coils and surgical clipping for intracranial aneurysms.

We report two cases in which combined surgical clipping and endovascular coils have been used to treat intracranial aneurysms. In one case, a 59-year-old woman with multiple episodes of subarachnoid hemorrhage had an anterior communicating artery aneurysm, which was initially treated with coils and then clipped to occlude the aneurysm securely. In the second case, a broad-based cavernous aneurysm could not be completely surgically occluded, but surgical clipping did decrease the aneurysm neck size, allowing it to be successfully treated with coils.

Adult↗
PubMed1994

[Clipping of aneurysm arising from the posterior communicating artery itself by contralateral craniotomy: a case report].

A case of aneurysm arising from the posterior communicating artery itself clipped by contralateral frontotemporal craniotomy (pterional approach) is presented. A 65-year-old female developed sudden severe headache and chest pain in January of 1993. Neurological examination on admission revealed consciousness disturbance such as stupor and nuchal stiffness. CT-scan showed marked subarachnoid hemorrhage. She also suffered from acute myocardial ischemia and cardiac failure. Cerebral angiograms after recovery from cardiac dysfunction demonstrated three saccular aneurysms arising from the dilated right posterior communicating artery itself, the junction of the left internal carotid artery and the posterior communicating artery, and the bifurcation of the left middle cerebral artery. The left IC-PC junction aneurysm was thought to be ruptured because of its size and contour, so left frontotemporal craniotomy was undertaken. By the left pterional approach, successful clipping of all three aneurysms involving the one arising from the contralateral posterior communicating artery was achieved. The aneurysm at the posterior communicating artery itself was found to arise from the non-branching site and to project inferiorly, thus the successful clipping through the prechiasmal cistern could be performed without compromising any small perforating arteries.

Aged↗
PubMed1993

[Anesthetic management for cesarean section and clipping of aneurysm in a pregnant woman with ruptured cerebral aneurysm].

We report an anesthetic management for Cesarean section and clipping of aneurysm in a pregnant woman with a subarachnoidal hemorrhage secondary to a ruptured cerebral aneurysm. Anesthesia was induced with thiopental, vecuronium and sevoflurane, and maintained with sevoflurane (0.5-1%) before the delivery. Apgar score at 1 min was 1, but after 30 min her activity became almost normal. After the delivery, anesthesia was maintained with fentanyl for clipping surgery, because sevoflurane may inhibit uterine contraction and increase bleeding from the uterus after the delivery. We also infused prostaglandin E1 continuously at a rate of 50-70 ng.kg-1.min-1 to control arterial blood pressure and to maintain good contraction of the uterus during clipping surgery. We conclude that prostaglandin E1 is useful as a vasodilator after delivery because prostaglandin E1 contracts the uterus.

Adult↗
PubMed1993

[Surgical treatment of ruptured dissecting aneurysms: proximal clipping vs trapping].

The best surgical treatment for ruptured dissecting aneurysms of the vertebral artery is still controversial. Four patients (1 male, 3 female), age ranging from 43 to 62, were operated upon in our department during the last 6 years. Duration from rupture to the operation was 0 to 4 days. In 2 cases, proximal clipping was the primary treatment, while 2 had a trapping. Antiplatelet agents were given to prevent vasospasm in all cases postoperatively. In proximal clipping cases, one patient had suffered from fatal rerupture on the sixth postoperative day. In trapping cases, Wallenberg syndrome developed in one patient. These results suggest that a proximal clipping may not allow the treatment for the vasospasm because of the danger of rebleeding and also a trapped segment of vertebral artery should be as short as possible to avoid compromised perforators.

Adult↗
PubMed1995

[Titanium aneurysm clips and their advantages in diagnostic imaging].

Aneurysms clips made of a titanium alloy (TiAl6V4) were used in clinical practice for the first time. The design of the clips is identical to the routinely used Yasargil series. In 30 patients, 38 symptomatic and asymptomatic aneurysms were fixed with 45 clips. Metallurgical advantages of the new alloy are better biocompatibility, less magnetic susceptibility, and lower X-ray density. The postoperative imaging results are superior to the conventionally used alloys with respect to artifact reduction in computed tomography, angiography, and magnetic resonance imaging. With a follow-up period of 7 months, a statement on biocompatibility cannot yet be given.

Alloys↗
PubMed1997

[Forum: Clips and coils in aneurysm treatment].

The treatment of cerebral aneurysms aims at the complete elimination of the aneurysm from the circulation. In the case of subarachnoid hemorrhage (SAH), early management prevents rebleeding and in incidental aneurysms, future rupture is to be prevented. Standardization of surgical techniques and optimized collateral measures have reduced the morbidity and mortality of early operations in SAH to 10% and 15%, respectively, in most series. As an alternative, endovascular techniques are being developed which attempt to obliterate the aneurysmal sack by packing it with detachable platinum-coils. A major difference between clipping and coiling is the closure of the aperture by the surgical clip which approximates the vessel walls. During coil embolization, that aperture stays open, allowing in some cases further compaction of the coils in subsequent months and years. Recanalization attributable to compaction depends on the size of the aneurysm and may necessitate repacking in up to 40% of the cases (aneurysms > 25 mm). As for the risk of rebleeding, a recanalized aneurysm is comparable to a partially clipped aneurysm. As the surgical results from early and delayed operations were obtained in randomized controlled studies, such randomized comparative studies will need to be applied to assess the value and risks and long-term results of endovascular strategies.

Aneurysm, Ruptured↗
PubMed1997

Use of CLIPS for representation and inference in a clinical event monitor.

We developed a clinical event monitor that is currently deployed in an inpatient setting. We selected CLIPS as the basis for its KB and inference engine. This paper describes the considerations that went into that decision, how we represented drug and laboratory knowledge in CLIPSs, and how we extended CLIPS to deal with temporal inferences. We also review the published literature about the use of CLIPS in medicine.

Clinical Pharmacy Information Systems↗
PubMedDate not supplied

[The clipping off of a giant fusiform aneurysm and the formation of a middle cerebral artery lumen by using a method for the intravascular aspiration of blood from the aneurysm].

The paper presents a 36-year-old patient in whom giant fusiform aneurysm of the M1 segment of the MCA was successfully clipped using intravascular aspiration technique. EEG was intraoperatively monitored. At surgery, the lumen of the deformed M1 segment was newly shaped by a series of 3 fenestrated clips. Intravascular aspiration of blood from the ipsilateral ICA significantly helped decrease blood volumes within the aneurysm and its size which facilitated dissection and clipping of the aneurysm. Since intravascular aspiration have been previously used during surgery of giant and large paraclinoidal aneurysms, this case demonstrates the benefits of the technique in the surgery of aneurysms located in the areas other than paraclinoid one.

Adult↗
PubMed1981

An applicator for the Hulka fallopian tube clip.

Use of the Hulka spring clip has advantages over other methods of occluding the fallopian tubes. Since difficulties were experienced with clip applicators from two manufactures, an improved applicator was designed. A similar applicator for use at minilaparotomy is described also.

Female↗
PubMed1991

Timing of postpartum tubal sterilization using the Filshie clips: an analysis of data from two developing-country centers.

Two-hundred-ninety-seven women at a Panamanian center and 148 women at a Philippine center had their tubal sterilization performed during their postpartum hospital stay after an uncomplicated vaginal delivery of a live birth. The sterilizations were all performed with the use of the Filshie clip via minilaparotomy. The timing of the sterilization varied from two hours to six days after delivery. At each of the two centers, women sterilized within 48 hours after delivery were compared with those sterilized at 49 or more hours with respect to surgical difficulties, tubal injuries, complications/complaints, technical failures and lengths of hospitalization after sterilization and before discharge. The one-year gross cumulative pregnancy rates were also compared. No significant differences were detected in any of the above outcome variables between the two timing groups at each center. While the data suggest that tubal sterilizations by the Filshie clip performed two to six days following childbirth are as safe and effective as those performed within 48 hours of delivery, further studies are urged.

Developing Countries↗
PubMed1980

Laparoscopic sterilization with electrocautery, silastic bands and spring-loaded clips: report of our experience with 790 patients.

A comparative study was carried out in 790 women undergoing one of the 3 most frequently used laparoscopic sterlization techniques: high-frequency unipolar electrocoagulation of the tubes, application of silastic rings or spring-loaded clips to the tubes. The technical problems and per- and postoperative (early) complications are assessed. The use of high-frequency unipolar current has been superseded by today's mechanical and non-electrical sterilization methods. The spring-loaded clip method appears to be a sterilization technique with a minimum of severe complications, and theoretically the greatest chances for possible refertilization.

Electrocoagulation↗