• Marios C Papadopoulos, Vinothini Apok, Frederick T Mitchell, David P Turner, Adrian Gooding, and John Norris.
• Department of Neurosurgery, Hurstwood Park Neurological Centre, Princess Royal Hospital, Haywards Heath, West Sussex, England, U.K.
• Neurosurgery. 2004 Apr 1; 54 (4): 966-70; discussion 970-2.

ObjectiveTo determine whether repeated use weakens titanium aneurysm clips, making them unsafe for clinical use.MethodsNine Yaşargil (titanium alloy) and five Spetzler (pure titanium) clips were subjected to clinically relevant maneuvers, and the effects on the closing force were assessed. Clips were considered unsafe if 1) the blades crossed, 2) the clips failed to close completely, or 3) the blood pressure could open them.ResultsYaşargil and Spetzler clips significantly (P < 0.01 for both) weakened, by 18.9% and 26.1%, respectively, after 10 minutes of sustained maximal opening. After 100 open-close cycles, Spetzler clips showed no change in closing force, but the closing force of Yaşargil clips decreased significantly (P < 0.01), by a further 12.0%.ConclusionRepeated use weakens Spetzler and Yaşargil clips. All Spetzler and all but one Yaşargil clips were deemed safe for clinical use at the end of the experiments.

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