A Case of Recurrent Internal Carotid Anterior Wall Aneurysm Short-term after the Wrap and Clip Method

Abstract

We describe a case of small anterior wall aneurysm of the essentially narrow internal carotid artery (ICA) in which during direct operation a large part of the dome tore and its dome wall became valvular. Therefore under temporary trapping the valvular dome wall was put back, and the wrap and clip method with Bemsheet instead of clipping was performed in order to avoid severe stenosis of the ICA. Bleeding from the aneurysm was thereby controlled but an aneurysm recurred from the distal part of the original aneurysmal sac shortly after the operation. The recurrence was attributed to the fact that the range of wrap and clip was the minimum to stop bleeding from the aneurysm. For a small anterior wall aneurysm of the essentially narrow ICA, the wrap and clip method is considered the best choice of treatment to prevent ICA stenosis by clipping. And in these circumstances, this method should be performed as extensively as possible to prevent a potential recurrent aneurysm.