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Aneurysm Surgery: Past, Present and Future

Aneurysm Surgery: Past, Present and Future. Mario Zuccarello, M.D. University of Cincinnati, Dept of Neurosurgery Mayfield Clinic. John Hunter (1728-1793) HUNTERIAN LIGATION. Hunterian Ligation. 461 patients with ICA ligation Mortality rate 20.7% Stroke rate 30%.

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Aneurysm Surgery: Past, Present and Future

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  1. Aneurysm Surgery:Past, Present and Future Mario Zuccarello, M.D. University of Cincinnati, Dept of Neurosurgery Mayfield Clinic

  2. John Hunter (1728-1793) HUNTERIAN LIGATION

  3. Hunterian Ligation • 461 patients with ICA ligation • Mortality rate 20.7% • Stroke rate 30% Sahs, Perret, &Locksley, 1969

  4. Egas Moniz (1874-1955) 1ST CEREBRAL ANGIOGRAPHY IN 1927

  5. Harvey Cushing (1869-1939) SILVER CLIP

  6. Walter Dandy (1886-1946) 1ST CLIP ON ICA ANEURYSM

  7. History of Aneurysm Clips

  8. Aneurysm Surgery: Past • Dandy “ clipping of aneurysms is hopeless” • As late as the 1960s mean mortality 28.7% • Merritt in 1963 advised surgery only for aneurysms with large associated hematomas

  9. “We need a different clip” Mayfield Connection • The problem • “How to clip a large basilar bifurcation aneurysm with a fragile neck and an adherent P1 segment” . . . Drake

  10. Mayfield Connection • 1969 development of the fenestrated clip The Cincinnati Post, March 28, 1970

  11. Del Maestro, J Neurosurg 92, 2000

  12. Proc Neurol Surg 9, 1978 Youmans 2, 1973

  13. M. Gazi Yasargil (1925- ) OPERATING MICROSCOPE MODERN CLIPS

  14. Modern Clips

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