Pitfall for Neck Clipping of Unruptured Cerebral Aneurysms in Accompanied with Atherosclerosis: Surgical Complications and Their Preventions During Clipping Surgery

Abstract

Summary: Three-dimensional CT angiography (3D-CTA) is a useful modality for planning in clipping surgery of cerebral aneurysms. In addition, maximum intensity projection (MIP) technique allows easy visualization of intramural calcification around the aneurysm. In the present study, we compared preoperative findings with intraoperative findings regarding atherosclerosis and encountered 2 cases of unruptured aneurysm with unexpected severe atherosclerosis, which considered potential limitations to the use of MIP image for preoperative planning. We discuss surgical techniques for both cases when the wall of the aneurysm and neighboring arteries are thick and atherosclerotic.