Wrapping Technique in Fusiform Aneurysms

Matías Baldoncini,

Published on: 2020-11-09


Although the presentation of cerebral aneurysms is variable, those of fusiform configuration in some cases are not possible to resolve through direct clipping. For this aneurysms, there are many surgical options, such as aneurysm trapping or reinforcement of the aneurysm dome. The evolution of the reinforcement technique has underwent many changes, as its origins lie in the pre-microsurgical era until today having non- biological materials. Clipping the neck of an aneurysm is generally considered the best choice of treatment for a ruptured aneurysm. However, most fusiform aneurysms do not have necks arising from the original vessel like saccular aneurysms, for this reason direct clipping is impossible and wrapping constitute a microsurgical alternative to prevent rerupture of the aneurysm. The goal of wrapping the aneurysm wall is not only for immediate reinforcement, but also stabilize the vascular wall and adhere to surrounding tissue and finally secure the aneurysm from rupture. We aim to bring to attention a tried-and-true method for surgical control of uncoilable and unclippable aneurysms such as these, and to describe step-by-step the technique of aneurysm wall reinforcement with wrapping and analyze the publications about the technique and results. In the future, experimental studies will be necessary to demonstrate the histological changes in the aneurysm wall with the use of natural cotton, polytetrafluoroethylene sheet or the combination generates on the arterial wall and the neighboring brain structures.

scroll up