Anterior clinoidectomy in low lying internal carotid artery-posterior communicating artery aneurysm.

Das, Kuntal Kanti; Singh, Guramritpal; Bhaisora, Kamlesh Singh; Srivastava, Arun Kumar · Acta Neurochir (Wien) · 2024

case_report · Level V

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Abstract

At times, a regulation internal carotid artery-posterior communicating artery junction (ICA-P-Comm) aneurysm becomes a surgical hurdle owing to its close proximity to the anterior clinoid process, an immovable ICA and a concealed dominant P-Comm artery arising from the aneurysm neck. A 70 year old patient with a low lying ICA-P-Comm aneurysm underwent a "tailored" intradural clinoidectomy for aneurysm clipping. A tailored anterior clinoidectomy to expose "just enough" allows a proximal ICA control in a suitable area, mobility of an atherosclerotic ICA and exposes the P-Comm artery origin which are essential in safe clipping of these aneurysms.

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