Temporary clipping of the parent artery in acute-stage aneurysm surgery was popularized by the late Prof. Jiro Suzuki. However, it is not rare that the internal carotid artery (ICA) proximal to the aneurysm cannot easily be identified even during surgery for ICA aneurysms of the common portion. In addition, the difficulty of identification of the ICA proximal to the aneurysm is not always predicted before the operation.
In this paper, authors emphasize that exposure of the common carotid artery in the neck of patients is highly recommended even in aneurysm surgery of the ICA (excluding the cavernous or opthalmic portion) in the cases shown below;
(1) when a ruptured aneurysm protrude posterioly, is located dorsally, or shows up small or large on the angiogram.
(2) when it is not possible to separate the aneurysm from the posterior communicating or anterior choroidal artery on the angiogram.
(3) when younger neurosurgeons perform the operation.
