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

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.