OPHTHALMIC ARTERY FED BY POSTERIOR COMMUNICATING ARTERY AFTER TRAPPING OF THE INTERNAL CAROTID-ARTERY

The authors report a 50-year-old man with a ruptured large carotid-oph thalmic aneurysm on the right side and an unruptured anterior communic ating artery (A Com) aneurysm. The A Comm aneurysm was clipped and the carotid-ophthalmic aneurysm was managed by combining internal carotid artery (ICA) trapping with an interposed radial artery graft from the external carotid artery (EGA) to the middle cerebra! artery (MCA). Th e patient had an uncomplicated postoperative recovery. Postoperative c arotid angiography demonstrated no aneurysms and excellent flow throug h the bypass graft. Postoperative vertebral angiography showed the rig ht ophthalmic artery to be fed by the posterior communicating artery. It is speculated that collateral circulation from the angular artery o f tile ECA to the ophthalmic artery did not develop because of high fl aw graft from the ECA to MCA and ICA trapping.