Usefulness of Both Blades-deviated Fenestrated Clips and Microvascular Doppler Sonography in Surgery of a Regrowthed and Reruptured Anterior Communicating Artery Aneurysm

The authors report the case of a 57-year-old male who presented with SAH due to recurrent rupture of regrowth of anterior communicating artery aneurysm which had been clipped 9 years before. The patient underwent surgery with the use of 2 blades-deviated fenestrated clips. The advantage of this type of clip for parallel application to the parent artery is presented. The usefulness of microvascular Doppler sonography for identification of the aneurysm and vital arteries around the aneurysm, which could not be identified visually because of severe adhesion due to encasement with Aron-alpha, is also discussed. Without these 2 apparatus, the aneurysm would not have been successfully clipped.