Y. Tanaka et al., MULTIPLE CLIPPING TECHNIQUE FOR LARGE AND GIANT INTERNAL CAROTID-ARTERY ANEURYSMS AND COMPLICATIONS - ANGIOGRAPHIC ANALYSIS, Journal of neurosurgery, 80(4), 1994, pp. 635-642
Experience with surgical clipping of 16 large and nine giant aneurysms
of the intradural internal carotid artery (ICA) is described. Reconst
ruction of the parent artery with part of the aneurysmal wall was nece
ssary in the majority of cases. Multiple clips were required for satis
factory clipping in 20 cases. Complications related to the clipping pr
ocedure comprised occlusion and stenosis of the parent carotid artery
in isolated cases. Straightening of the parent carotid artery with con
sequent kinking of the middle cerebral artery was seen in three cases
of an aneurysm with a dome directed ventrally in the proximal segment
of the ICA. The factors that caused straightening of the ICA are analy
zed. It was observed that an excessive change in the direction of the
ICA can cause cerebral infarction.