Kinked perforator due to clipping of parent vessel aneurysm: technical note and lessons learned

Jorn Van Der Veken; Michael J. Mulcahy; Timothy J. Harrington; Nazih N. Assaad

doi:10.1016/j.wneu.2019.05.131

Kinked perforator due to clipping of parent vessel aneurysm

technical note and lessons learned

Jorn Van Der Veken^*, Michael J. Mulcahy, Timothy J. Harrington, Nazih N. Assaad

^*Corresponding author for this work

Department of Clinical Medicine

Research output: Contribution to journal › Article

Abstract

Background: Adverse outcomes after aneurysm clipping can be potentially reversible, when managed appropriately. Methods: This is a case report describing kinking of a perforator due to clipping of parent vessel aneurysm. Results: Complete recovery of a high-grade motor deficit was achieved after instant reintervention with application of smaller clips in combination with gelfoam soaked in papaverine. Conclusion: Use of evoked potentials and intraoperative digital subtraction angiography are recommended and may help in preclinical diagnosis. Knowledge of delayed perforator kinking as a complication may lead to a more rapid diagnosis and management.

Original language	English
Pages (from-to)	473-476
Number of pages	4
Journal	World Neurosurgery
Volume	128
DOIs	https://doi.org/10.1016/j.wneu.2019.05.131
Publication status	Published - 1 Aug 2019

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Keywords

Clipping
Kinked
Perforator

Cite this

Van Der Veken, J., Mulcahy, M. J., Harrington, T. J., & Assaad, N. N. (2019). Kinked perforator due to clipping of parent vessel aneurysm: technical note and lessons learned. World Neurosurgery, 128, 473-476. https://doi.org/10.1016/j.wneu.2019.05.131

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abstract = "Background: Adverse outcomes after aneurysm clipping can be potentially reversible, when managed appropriately. Methods: This is a case report describing kinking of a perforator due to clipping of parent vessel aneurysm. Results: Complete recovery of a high-grade motor deficit was achieved after instant reintervention with application of smaller clips in combination with gelfoam soaked in papaverine. Conclusion: Use of evoked potentials and intraoperative digital subtraction angiography are recommended and may help in preclinical diagnosis. Knowledge of delayed perforator kinking as a complication may lead to a more rapid diagnosis and management.",

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AU - Van Der Veken, Jorn

AU - Mulcahy, Michael J.

AU - Harrington, Timothy J.

AU - Assaad, Nazih N.

PY - 2019/8/1

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N2 - Background: Adverse outcomes after aneurysm clipping can be potentially reversible, when managed appropriately. Methods: This is a case report describing kinking of a perforator due to clipping of parent vessel aneurysm. Results: Complete recovery of a high-grade motor deficit was achieved after instant reintervention with application of smaller clips in combination with gelfoam soaked in papaverine. Conclusion: Use of evoked potentials and intraoperative digital subtraction angiography are recommended and may help in preclinical diagnosis. Knowledge of delayed perforator kinking as a complication may lead to a more rapid diagnosis and management.

AB - Background: Adverse outcomes after aneurysm clipping can be potentially reversible, when managed appropriately. Methods: This is a case report describing kinking of a perforator due to clipping of parent vessel aneurysm. Results: Complete recovery of a high-grade motor deficit was achieved after instant reintervention with application of smaller clips in combination with gelfoam soaked in papaverine. Conclusion: Use of evoked potentials and intraoperative digital subtraction angiography are recommended and may help in preclinical diagnosis. Knowledge of delayed perforator kinking as a complication may lead to a more rapid diagnosis and management.

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KW - Perforator

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10.1016/j.wneu.2019.05.131

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