Game programmers spend their careers writing C++ where, yes, you really need tricks like this to rename the variable, as the language is so fucking insane that ALL tooling gets it wrong - and the consequences of getting it wrong can be disastrous.

The most widely used options for C++ are VS's IntelliSense and clangd. IntelliSense is utter garbage, I never trust it for renaming things. clangd is better but can still get things wrong if your build process is complicated your compile_commands.json doesn't perfectly reflect it.

Managed languages have fantastic tooling with perfect context of your project, but they're also managed and are not applicable in a lot of environments.

Yes, clangd is accurate but when you have different build variants only one is reflected in the current compilation database. clangd will be perfectly accurate for this current variant, but blind to others.

Would clangd support a merge of several compilation DB into one? If a file appears several times with different options (typically include paths and defines), would clangd handle all variants in parallel or just pick one (first or last)? I haven't tried (yet ;).

It's manageable, and sometimes I'm reverting to pure "text level" changes or searches to work around this.