TITANIUM ANEURYSM CLIPS .3. CLINICAL-APPLICATION IN 16 PATIENTS WITH SUBARACHNOID HEMORRHAGE

THIS REPORT DESCRIBES the first clinical use of newly developed titani um clips in the treatment of 16 patients with subarachnoid hemorrhage. There were no immediate or delayed complications related to the titan ium clips. Thirteen patients had good outcomes, and one patient had mo derate disabilities (mean follow-up, 5.4 mo). Two patients with Hunt a nd Hess Grade IV hemorrhages died postoperatively. The average cross-s ectional areas of clip artifact on postoperative magnetic resonance im aging studies was 0.96, 1.36, and 1.05 cm(2) on T1-, T2-, and intermed iate-weighted images, respectively. In comparison, a matched control g roup with cobalt alloy clips had average cross-sectional areas of 3.13 , 3.70, and 2.81 cm(2) on T1-, T2-, and intermediate-weighted images, respectively. The average artifact volumes on gradient echo magnetic r esonance images for titanium and cobalt alloy clips were 1.8 and 10.1 cm(3) respectively. In addition, the gap on magnetic resonance imaging angiograms from clip artifacts was 0.9 cm with titanium and 2.6 cm wi th cobalt alloy clips. In conclusion, titanium aneurysm clips seem to be safe and effective and seem to reduce clip artifacts on magnetic re sonance imaging threefold, compared with commercially available cobalt alloy clips. Because of this important advantage over conventional cl ips, titanium clips should be considered for routine use in aneurysm s urgery.