Surgical management of an intracranial aneurysm is mainly clipping. Various types of clips have been designed for complex, giant, and other aneurysms. Recently, the Yasargil-fenestrated T-bar clip has been introduced for the management of such complicated aneurysms. The literature regarding its efficacy, limitations, and method of application in complicated aneurysms is limited. We used the fenestrated T-bar clip in four patients of intracranial aneurysms - middle cerebral artery cortical branch aneurysm, anterior communicating artery partially thrombosed aneurysm, internal carotid artery paraclinoid simple aneurysm, and giant aneurysm. All aneurysms were successfully clipped with no residue or branch occlusion. The recovery of all patients was satisfactory. The fenestrated T-bar clip effectively reconstructed the parent artery and occluded the aneurysm in all cases. The application of this clip may be advantageous over the clip application in some uniquely challenging cases.
Keywords: Aneurysm; anterior communicating artery; fenestrated T-bar clip; internal carotid artery; middle cerebral artery.