281-543-5251 | Contact Us 2401 Fountain View Dr, Ste 312 PMB 12, Houston, TX 77057
Donate

Knuckling Up for Brain Aneurysms, AVMs & Hemorrhagic Strokes
  • Give
    • Apparel
    • Other Ways to Give
    • GIVING
    • Gifts in Honor
  • About Us
    • Staff
    • Board of Directors
    • Medical Advisory Board
    • Our Mission
    • Partners
    • Contact Us
  • Education
    • Understanding
      • Brain Basics
      • What is an Aneurysm?
      • What is an AVM?
      • What is a Hemorrhagic Stroke?
      • Types of Cerebral Aneurysms
      • Factors of a Brain Aneurysm
      • Symptoms of a Brain Aneurysm
      • Dangers of a Brain Aneurysm
      • How Does a Brain Aneurysm Develop?
      • What Happens When an Aneurysm Bleeds?
      • How is a Brain Aneurysm Diagnosed?
    • Treatment
      • Unruptured Aneurysm
      • Ruptured Aneurysm
      • Clipping
      • Occlusion and Bypass
      • Endovascular Embolization / Coiling
      • Flow Diversion
      • Onyx Liquid Embolic System
      • Gamma Knife
      • Questions to Ask Your Doctor
      • Should I Get a Second Opinion?
      • Treating Physicians
  • Support
    • Support Groups
      • Support Group Locations
    • Recovery
      • Denial
      • Anger and Frustration
      • Depression
      • Bargaining
      • Acceptance
      • Post Recovery Issues
    • Caregivers
      • What a Caregiver Needs to Know
      • Recharging and Finding Balance
      • Looking After Yourself
    • What to Expect
  • Connect
    • Contact Us
    • Social Media
      • Facebook
        • Patients Online Support Group
        • Caregivers Online Support Group
        • Young Adult Online Survivor’s Support Group
        • Parents Online Support Group
        • Honoring the Taken Online Support Group
      • Twitter
      • Instagram
      • YouTube
      • LinkedIn
    • Stories
      • Survivors Around the Globe
      • The Caregiver’s Side
      • Honoring the Taken
      • Submit Your Story
    • Webinars
    • Blog
    • Knuckle Up Newsletter
  • Events
    • Knuckle Ball 2023
    • 2022 Virtual 5K: Walk. Run. Row. Cycle.
  • Grants
    • Joe Niekro Research Grant
      • Letter of Intent
      • Grant Application
      • Grant Recipients
    • Joe Niekro/SNIS Research Grant
    • Joe Niekro Patient’s Choice Award
    • Joe Niekro Crystal Bat Award
Home > Treatment > Clipping
  • Gamma Knife
  • Questions to Ask Your Doctor
  • Unruptured Aneurysm
  • Ruptured Aneurysm
  • Clipping
  • Occlusion and Bypass
  • Endovascular Embolization / Coiling
  • Flow Diversion
  • Onyx Liquid Embolic System
  • Should I Get a Second Opinion?
  • Treating Physicians

Clipping

Clipping is a surgical procedure, performed by a neurosurgeon, to treat a brain aneurysm.  An incision is made in the skin over the head and through the bone to dissect within the spaces of the brain and place a clip across the aneurysm where it arises from the blood vessel. This prevents the blood flow from entering the aneurysm.

The clip works like a tiny coil-spring clothespin, in which the blades of the clip remain tightly closed until the pressure is applied to open the blades. Clips are made of titanium and remain on the artery permanently.


Animation of virtual aneurysm clipping procedure

Microvascular clipping involves cutting off the flow of blood to the aneurysm. Under anesthesia, a section of the skull is removed and the aneurysm is located. The neurosurgeon uses a microscope to isolate the blood vessel that feeds the aneurysm and places a small, metal, clothespin-like clip on the aneurysm’s neck, halting its blood supply. The clip remains in the patient and prevents the risk of future bleeding. The piece of the skull is then replaced and the scalp is closed. Clipping has been shown to be highly effective, depending on the location, shape, and size of the aneurysm. In general, aneurysms that are completely clipped surgically do not return.

Clipping may be an effective treatment for the following:

Ruptured aneurysms burst open and release blood into the space between the brain and skull, called a subarachnoid hemorrhage (SAH). The risk of repeated bleeding is 35% within the first 14 days after the first bleed. So, timing of surgery is important – usually within 72 hours of the first bleed. Vasospasm is a common complication of SAH, which must be closely managed after treatment to prevent stroke.

Unruptured aneurysms may not cause symptoms and are typically detected during routine testing. People with a family history of brain aneurysms should have a screening test (CT or MR angiogram). The risk of aneurysm rupture is about 1% per year but may be higher or lower depending on the size and location of the aneurysm. However, when rupture occurs, the risk of death is 40%, and the risk of disability is 80%.

Clipping vs. Coiling

Comparing the long-term results of coiling vs. clipping of aneurysms is an area of ongoing study.  Clipping has proven its long-term effectiveness over several decades.  In recent years, coiling has gained acceptance as an alternative to clipping for treatment of ruptured subarachnoid hemorrhage (SAH).  There have been considerable advances in open surgery techniques. Many neurosurgeons can now perform mini craniotomies, or eye brow incisions to clip an aneurysm. In select patients a small incision is made over the eyebrow. A small two inch window is then made in the bone over the eye and through this incision a small clip is placed across the opening of the aneurysm. These patients usually spend 1-2 days in the hospital after surgery and then go home. Patients are usually on light restricted activity for 1-2 months after surgery. However, it is still an invasive procedure and takes longer to recover from than a coiling procedure.


Illustration showing a side by side view of the coiling and the clipping procedure

Common Questions

  • What is a brain aneurysm?
  • What is an AVM?
  • What is a hemorrhagic stroke?
  • What are the risk factors of a brain aneurysm?
  • What are the symptoms of a brain aneurysm?
  • What are the dangers of a brain aneurysm?
  • How does a brain aneurysm develop?
  • How is a brain aneurysm diagnosed?

Upcoming Events

  • Knuckle Ball 2023
  • 2022 Virtual 5K: Walk. Run. Row. Cycle.

News Room

  • Stories
  • Videos
  • Knuckle Up Newsletter

Connect with Us

  • Subscribe to our Knuckle-Up Newsletter
  • Become a Fan on Facebook
  • Follow us on Twitter
  • Follow us on Instagram
  • Join our Online Aneurysm/AVM Support Group
  • Join our Online Parents Support Group
  • Join our Online Young Adult Survivor’s Support Group
  • Join our Online Aneurysm/AVM Caregivers Support Group
  • Join our Online Honoring the Taken Support Group
  • Support Group Locations
  • Contact Us
  • References
  • Privacy Policy
© 2023 Joe Niekro Foundation. All Rights Reserved.
  • Donate

    Every donation matters - every dollar counts. The Joe Niekro Foundation is a registered 501 (c)(3) which means your donations are 100% tax deductible. Your donations are used to enhance the research and treatment of brain aneurysms, AVM and hemorrhagic strokes, while supporting patients and families through the recovery process.

    Donate Now!
  • Newsletter Sign Up

    The best way to keep up to date on all the JNF happenings. Sign up today for our Knuckle Up Newsletter!