The Application And Efficacy Analysis Of Yasargil T-bar Aneurysm Clip In Microsurgical Clipping Of Intracranial Aneurysms

Background:The microclipping treatment of modern intracranial aneurysms is becoming more and more perfect,and the aneurysm clip is also updated in the clinical practice of neurosurgery.The new generation of windowing aneurysm clip-Yasargil T-Bar clip shows its unique advantages in the treatment of some complex aneurysms,and also provides a direction for neurosurgeons to further explore and study complex aneurysms.Objective:To study the effectiveness,surgical technique and clinical experience of Yasargil T-Bar clip in the clipping of intracranial aneurysms.Materials and methods:The cases of subarachnoid hemorrhage(subarachnoid hemorrage,SAH)diagnosed by CT,intracranial aneurysms(intracranial aneurysm,AN)further diagnosed by CTA or DSA and microclipped with Yasargil T-Bar titanium alloy clip in the Department of Neurosurgery of the first Hospital of Jilin University from January 2018 to December 2019 were analyzed retrospectively.A total of 7 cases were screened,and the type,location,size and direction of intracranial aneurysms,the size and number of T-Bar clips(inclination angle,blade diameter,closing force,etc.),HH,Fisher and GCS grades,operative methods,intraoperative secondary rupture,complications and prognosis of MRS and GOS scores were calculated.Then further analyze the effectiveness and limitations of Yasargil T-Bar titanium alloy clip in the application of complex aneurysms,so as to further explore surgical techniques and summarize clinical experience in order to guide the treatment and prognosis.Results:Seven patients recovered well after operation,and no limb movement disturbance was found when they were discharged from hospital.Only one patient still had oculomotor nerve paralysis symptoms such as ptosis,pupil dilation and disappearance of light reflection.Head CTA or DSA follow-up was performed 6-12 months after discharge,there was no aneurysm recurrence,4 cases had no parent artery stenosis,1 case had 10% stenosis,1 case had 15% stenosis,1 case had 20% stenosis,all had no clinical symptoms,and the collateral circulation was good.Telephone follow-up ranged from 6 months to 2 years.The m RS score was 1 in 7 cases,and there was no new neurological and limb dysfunction.Conclusion:Seven patients recovered well after operation,and no limb movement disturbance was found when they were discharged from hospital.Only one patient still had oculomotor nerve paralysis symptoms such as ptosis,pupil dilation and disappearance of light reflection.Head CTA or DSA follow-up was performed 6-12 months after discharge,there was no aneurysm recurrence,4 cases had no parent artery stenosis,1 case had 10% stenosis,1 case had 15% stenosis,1 case had 20% stenosis,all had no clinical symptoms,and the collateral circulation was good.Telephone follow-up ranged from 6 months to 2 years.The m RS score was 1 in 7 cases,and there was no new neurological and limb dysfunction.