Evaluation of a clip-reinforced wrapping technique with collagen-impregnated Dacron for intracranial aneurysms inaccessible to other treatment

•Improving the management of small intracranial aneurysms with particular shape.•Describe a new technique when traditional methods failed.•Performance of the ‘Clip-assisted Dacron wrapping of aneurysm’.•Use of a material without side effects or reaction around the vessel.

ObjectiveTo describe our clip-reinforced wrapping technique (CRW) with collagen-impregnated Dacron and report our experience in intracranial aneurysms (IA) untreatable by coil embolization (CE) or surgical clipping (SC).MethodsBetween July 2003 and November 2010, CRW was performed on 20 IAs in 18 patients using a collagen-impregnated Dacron fabric (Hemashield®, USA) fixed with a clip around the parent vessel and the IA.ResultsTwo patients (11%) died of complications from their subarachnoid hemorrhage and preexisting conditions. In the remaining 16 patients, after an average follow-up of 45 months (min: 27, max: 77), 16 (89%) out of the 18 treated aneurysms were no longer visible and two were reduced and stable.ConclusionOur preliminary results suggest that CRW with Hemashield could be an accurate and safe alternative technique for some IA without any other treatment option.ImplicationsDescription of an alternative surgical technique for otherwise untreatable intracranial aneurysms.