A Case of Giant Thrombosed Internal Carotid Artery Aneurysm Treated Using Endovascular Treatment and Surgical Thrombectomy

Abstract

Giant thrombosed internal carotid artery (ICA) aneurysms are difficult to treat with neck clipping or aneurysmal coiling. Parent artery occlusion (PAO) of the ICA is an alternative treatment that requires a balloon test occlusion (BTO) to evaluate the ischemic tolerance and need for various types of bypass surgeries. However, the BTO evaluation methods vary according to the facility, and no guidelines are available. The indication for revascularization is important when selecting the necessary bypass surgery using multimodality evaluation with BTO before the treatment of cerebral aneurysms requiring PAO.