A comprehensive review of aneurysm clip materials and artifact reduction techniques

Abstract

High-resolution imaging is critical for the diagnosis, treatment planning, and postoperative monitoring of cerebral aneurysms, which affect up to 5% of the population and pose a significant risk of rupture and subarachnoid hemorrhage. Surgical clipping remains a definitive treatment option, but metallic clips can introduce substantial imaging artifacts, complicating posttreatment assessment. This review synthesizes current knowledge on the impact of aneurysm clip materials and designs on artifact generation and explores strategies for artifact mitigation. Conventional materials like titanium are favored for their biocompatibility and reduced ferromagnetism but still cause beam hardening, streak artifacts, and signal loss in CT and MRI scans. Emerging alternatives, including ceramics, composites, polymers, and bioresorbable clips, show promise in reducing artifacts while maintaining mechanical reliability. Innovations in clip design, such as fenestrated or low-profile models, further aid in minimizing imaging distortion. Advanced imaging methods, including dual-energy CT, iterative reconstruction algorithms, and metal artifact reduction software, demonstrate significant improvements in image quality but may introduce limitations such as increased processing demands or subtle anatomical distortions. Future directions emphasize the development of next-generation clip materials, robotic-assisted surgical approaches, and artificial intelligence-driven reconstruction techniques to further optimize visualization and patient safety. Continued research and multidisciplinary collaboration will be essential to translate these innovations into routine neurosurgical practice.