Abstract
Aneurysms with a diameter of more than 13mm (global aneurysms) arising from the parasellar portion of the internal carotid artery (IC) present a special surgical problem.The topographical region, the size, and the thickness of the aneurysmal neck wall all pose problems in attempt to clip such aneurysms.
This report describes a technique successfully used with global aneurysm.
The aneurysms were approached by the standard pterional approach. Then, when the aneurysmal neck had been suitably prepared for application of a clip by freeing it of the surrounding tissues, temporary clips were applied at the distal and proximal parts of the aneurysm of the IC and at the posterior communicating artery.
The aneurysmal dome was then punctured with a needle and the blood aspirated with the needle in place. The aneurysmal neck was then occluded by an aneurysm clip.
The postoperative course in both cases was uneventful.
The advantages and shortcomings of the procedure are discussed.
