====== Clip remodeling ======

Zhu et al. discussed the value and technique of [[clip]] [[remodeling]] in microsurgical [[treatment]] of [[intracranial aneurysm]]s via [[keyhole]] [[approach]]es. 

The clinical [[data]] of patients with intracranial aneurysms, who were treated by microsurgical [[clipping]] via keyhole approaches from January 2017 to December 2019, were [[retrospective]]ly analyzed. The [[clip]]s were remodeled based on the aneurysmal characteristics during the [[procedure]] in 27 cases. [[Angiography]] was obtained within one week after surgery in order to evaluate the position of clips and the security of lesions. All patients were followed up at the [[outpatient]] clinic to assess the clinical [[outcome]]s. 

A total of 27 patients harbored 30 [[intracranial aneurysm]]s, including 23 ruptured lesions and 7 [[unruptured]] ones. There were 9 [[middle cerebral artery aneurysm]]s, 11 [[anterior communicating artery aneurysm]]s, 9 [[posterior communicating artery aneurysm]]s, and 1[[ anterior cerebral artery aneurysm]], respectively. Nine patients were operated via a [[supraorbital]] [[keyhole approach]], as well as 17 via [[Mini-Pterional Craniotomy]] and one via [[interhemispheric]] keyhole approach. Postoperative angiography revealed complete obliteration of lesions without residual filling in all cases. Twenty-five patients recovered well at discharge and two presented with mild disability. After 3-36 months of follow-up, no rebleeding and new-onset neurological deficits were noted. 

Clip remodeling technique is a simple and effective option, which can alleviate the limitation of manipulative freedom under keyhole approaches and improve the microsurgical effect of [[intracranial aneurysm clipping]]
((Zhu Q, Chen AL, Dai CG, Cao DD, Wu T, Wu Y, Lan Q. [Application of clip remodeling technique in microsurgical treatment of intracranial aneurysms via keyhole approaches]. Zhonghua Yi Xue Za Zhi. 2021 Jan 12;101(2):152-156. Chinese. doi: 10.3760/cma.j.cn112137-20200416-01211. PMID: 33455133.)).