Brain aneurysm clipping surgery is used to prevent or treat a ruptured aneurysm, a life threatening emergency.

A brain aneurysm is a bulging area of a blood vessel in your brain. If a brain aneurysm ruptures, it can lead to a stroke. Clipping surgery involves using a metal clip to isolate the aneurysm from the rest of the circulation in your brain to prevent or treat a ruptured aneurysm.

Clipping surgery is an extensive procedure, but it can be lifesaving. Brain aneurysms that rupture have a high risk of causing death or permanent disability.

Read on to learn more about brain aneurysm clipping, including when it’s performed, what the potential risks are, and how effective it is.

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Brain aneurysm surgical clipping. | Wenzdai Figueroa.

Brain aneurysm clipping surgery is used to prevent or treat a ruptured brain aneurysm. A ruptured aneurysm can lead to a hemorrhagic stroke, which can happen when leaking blood puts pressure on your brain cells and causes brain damage.

An estimated 3.2% of people have brain aneurysms, although most don’t have symptoms and only a small percentage of those aneurysms rupture. According to a 2023 research analysis, the annual rupture rate is 2% to 10%.

A ruptured brain aneurysm causes death in around 20% of cases, and another 30% to 40% of survivors have complications.

In a 2019 review of 114 studies, researchers found that the risk of complications from surgical treatment for unruptured brain aneurysms was 8.34% and the death rate was 0.1%.

Potential side effects of this surgery include:

Brain aneurysm clipping can be a lifesaving procedure for people who need it.

In a 2024 review, researchers compared the success rates of aneurysm clipping and endovascular surgery (another type of surgery commonly used to treat brain aneurysms). They found that at a median follow-up of 6.1 years, the re-rupture rate was 0.5% for the clipping group and 1.5% for the endovascular group.

Other studies have reported success rates of more than 95% for clipping surgery.

Here’s a look at what you can expect before, during, and after brain aneurysm clipping surgery.

Before the procedure

Brain aneurysm clipping surgery is usually performed in a neurosurgical ward. You’ll change into a hospital gown and sign a consent form for your procedure. Your surgical team will explain the procedure and answer any questions you may have.

During the procedure

Here’s a general idea of what to expect during your procedure:

  1. The surgical team will give you general anesthesia through an IV to put you to sleep for the procedure. Usually, the IV will be connected to a vein in your wrist or arm.
  2. The surgical team may shave a small amount of your hair, depending on where your aneurysm is located.
  3. Your surgeon will cut into your scalp to reveal part of your skull. They’ll make small holes in your skull and connect them to remove a “bone flap.”
  4. Your surgeon will open the protective covering around your brain, called the dura, and use a microscope to find the aneurysm.
  5. They’ll place a tiny metal clip over the bulging part of your blood vessel.
  6. Your surgeon will put the bone flap back into place and secure it with metal plates and screws. They will then close your wound with stitches and cover it with bandages.

How long does an aneurysm clipping surgery take?

Brain aneurysm clipping surgery is an extensive procedure that can take around 5 hours.

After the procedure

After your procedure, you’ll be connected to machines to monitor your vital signs and to a ventilator to help you breathe. You’ll likely be sedated for at least 1 day.

When you wake up in the recovery area, you’ll be connected to an IV and will likely have a catheter in your bladder and a drain connected to your wound.

Brain aneurysm clipping surgery is performed under general anesthesia, meaning you’ll be asleep during your procedure. If your surgery is in the morning, you’ll likely need to stop eating the night before and won’t be able to drink anything for hours before your procedure.

Surgeons often recommend quitting smoking before surgery to reduce your risk of complications.

It’s important to get plenty of rest after an aneurysm clipping. You’ll need to avoid getting your surgical wound wet for at least 72 hours and avoid strenuous activities for about 4 weeks.

What is the recovery time for brain aneurysm clipping surgery?

The recovery time varies, but you can expect to be in the hospital for 2 to 5 days after a scheduled surgery. If you had surgery for a ruptured aneurysm, you might need to be in the hospital for 7 to 14 days.

How long does recovery take?

It often takes 6 to 8 weeks to fully recover from brain aneurysm clipping. You might have fatigue for up to 6 months if you’ve had surgery after a ruptured aneurysm.

Brain aneurysm clipping postsurgery complications

After this procedure, some people have permanent brain damage that causes:

  • problems with movement
  • seizures
  • problems with sensation
  • other changes in the ability to think

Headaches and fatigue are common after this procedure. But it’s important for you or someone nearby to contact emergency medical services if you experience any of the following symptoms:

  • vomiting
  • collapse
  • severe headache

The cost of your procedure will depend on factors like where the procedure takes place and the experience of your surgeon.

The nonprofit FAIR Health estimates that 80% of procedures for the repair of complex aneurysms of back brain arteries in Oregon City, a suburb of Portland, Oregon, cost less than $24,474 without insurance, with anesthesia potentially costing another $8,721.

Insurance providers, including Medicare, often cover some or most of the expense when your procedure is medically necessary.

Endovascular coiling is the other main type of surgery used to treat brain aneurysms. This procedure is less invasive and involves inserting a thin tube through your bloodstream until it reaches the aneurysm. Your surgeon uses this tube to place a stent over your aneurysm so blood can pass through without risk of rupture.

Here are some frequently asked questions about brain aneurysm clipping surgery.

What is the survival rate for unruptured brain aneurysm surgery?

The risk of death during brain aneurysm clipping is very low. It’s about 1 in 1,000.

What is the life expectancy after aneurysm clipping surgery?

If your surgery is successful, your life expectancy might be comparable to that of a person who hasn’t had a brain aneurysm.

What is life like after aneurysm clipping surgery?

Once you fully recover, you’ll likely return to your usual life with few or no long-term complications. If you smoke, doctors will usually recommend quitting smoking since smoking is a risk factor for aneurysm formation.

Ruptured aneurysms come with a high risk of death or permanent disability.

But not all brain aneurysms require treatment, and your healthcare team can help you decide whether you may benefit from clipping surgery or a less invasive procedure called endovascular coiling.