High-flow Bypass with Proximal Artery Occlusion as a Therapeutic Option for Recurrent Large Internal Carotid Paraclinoid Aneurysm after Endovascular Surgery

Abstract

Here we described the case of a 57-year-old woman with a incidental large internal carotid paraclinoid aneurysm which recurred soon after stent-assisted coiling. Angiography revealed constant filling of the aneurysm dome, with no space for neck clipping; however, the patient rejected further endovascular surgery. Extracranial-intracranial high-flow bypass with internal carotid artery ligation in the neck was successfully performed without any sequelae. No recurrence was detected at 12 months after bypass surgery. We propose that paraclinoid aneurysms that persist after endovascular surgery or are unclippable may be treated with high-flow bypass with parent artery occlusion.