Stent-Assisted Clip Placement for Complex Internal Carotid Artery Intracranial Aneurysms

Abstract

Background—We report two procedures using a stent-assisted microsurgical clip placement to treat complex intracranial aneurysms originating from supraclinoid segment of the internal carotid artery.
Case Descriptions—In both procedures, primary clip placement was considered technically difficult due
to either complex morphology or inferior protrusion of aneurysm fundus within the interclinoid space. A
nitinol self-expanding stent was placed across the neck of the aneurysm either preoperatively or intraoperatively. Obliteration of aneurysm and patency of the artery was confirmed by angiography after clip placement.
Conclusion—Description of an integrated open microsurgical and endovascular approach and review of
literature pertaining to considerations for treatment approach are discussed.