Temporary clips are invaluable safety tools during the clipping of an aneurysm. Controversies
regarding maximum permissible duration and safety, however, remain unanswered. This
descriptive narrative attempts to review the literature to provide valuable insights
on controversies clouding the use of temporary clips among neurosurgeons. Popular
databases, including Pub Med, Medline/Medscape, Scopus, Cochrane, Embase, Google Scholar,
were searched to find available literature on temporary clips. The searched MeSH terms
were “Temporary Clip,” “Temporary Clipping,” “Cerebral Aneurysm,” and “Aneurysm.”
Temporary clips have been in use since 1928 and have undergone considerable structural
and technical modifications. A temporary clip's optimal safety limit is not yet defined
with literature evidence ranging from immediate to 93 min. It is not yet definite
whether temporary clips application aggravates vasospasm, but emergency temporary
clips application, especially in poor-grade aneurysmal subarachnoid hemorrhage patients,
is associated with poor outcomes. A temporary clip needs to be applied with caution
in patients treated earlier by endovascular technique and having indwelling stents.
Nitinol Stent is feasible, while a Cobalt-Chromium alloy stent does not get occluded
and gets deformed under the closing pressure of a temporary clip. Although a temporary
clip application is a fundamental strategy during the clipping of an aneurysm; the
exact safe duration remains to be decided in randomized control trials. Their utility
for the shorter duration is beneficial under un-conclusive evidence of neuroprotective
agents and intraoperative monitoring. Neurosurgeons need to consider all aspects of
their pros and cons for optimal use.
Key-words:
Aneurysm - temporary clip - temporary clipping
