“…Moreover, access to the VBJ is difficult and hampered by the petrous bone and the direct proximity of the aneurysm to the brain stem, perforating arteries and lower cranial nerves makes the approach dangerous. Selected cases may benefit from indirect therapies, such as proximal arterial occlusion and aneurysm trapping, with or without flow replacement, but these procedures may increase the operative risk and compromise the post-operative outcome 4,5,10,40,41,46,50 . In some other situations combined endovascular/microsurgiAspirin therapy was stopped four months after endovascular treatment.…”