Case report reveals successful combined bypass, clipping, and coiling in a patient with a giant MCA aneurysm, highlighting the feasibility of hybrid surgical and endovascular procedures.
We report an 18-year-old female with a left unruptured giant middle cerebral artery (MCA) aneurysm, 30.2 mm in diameter. It was non-bifurcation and located on the M1 segment. Distal M1 branched from aneurysm dome. After left superficial temporal artery to MCA bypass, coil embolization for the aneurysm and distal M1 clipping was simultaneously performed. During procedure, motor evoked potential monitoring showed no change. Although treatment of a giant MCA non-bifurcation aneurysm is challenging and there is no reliable treatment for them, endovascular and surgical combined treatment in the hybrid operation suite is one of the useful treatment options.
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Kuwajima et al. (2022) studied this question.
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