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

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Presentation transcript:

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

John Hunter ( ) HUNTERIAN LIGATION

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

Egas Moniz ( ) 1 ST CEREBRAL ANGIOGRAPHY IN 1927

Harvey Cushing ( ) SILVER CLIP

Walter Dandy ( ) 1 ST CLIP ON ICA ANEURYSM

History of Aneurysm Clips

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

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

Mayfield Connection  1969 development of the fenestrated clip The Cincinnati Post, March 28, 1970

Del Maestro, J Neurosurg 92, 2000

Proc Neurol Surg 9, 1978 Youmans 2, 1973

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

Modern Clips