Anatomy and Surgery for Internal Carotid Aneurysm at the Bifurcation of the Posterior Communicating Artery

Abstract

Internal carotid aneurysms at the bifurcation of the posterior communicating artery are common, but require some surgical techniques to be clipped in a safe manner. We must carefully observe the location of the posterior communicating artery as well as the perforating arteries, which should always be preserved. The dome of the aneurysm sometimes adheres to the tissues of the skull base and the pressure of the aneurysm is high. Therefore, proximal flow control is sometimes necessary when clipping aneurysms to prevent the aneurysm from rupturing. Because there was arteriosclerosis of the ophthalmic segment of the internal carotid artery, proximal flow control was undertaken at the cervical portion. Knowledge of the anatomy and variations of aneurysms at this portion and basic surgical techniques were necessary to finish the surgery without causing a catastrophic sequel.