Hi to all,
I am attaching the images of a recently done case. This is a 20 years old boy who has an incidentally detected giant left ICA supraclinioid segment aneurysm. He doesnot have neither anterior nor posterior communicating artery, we did a baloon test occlusion to consider a possible sacrification and combined endovascular and surgical treatment but left ICA was completely isolated. The anterior choroidal artery was coming out of the aneurysmal sac.
We could reconstruct the ICA with 4 pipelines starting from MCA towards ICA. ACA postoperative was intact and there was an obvious stagnation of the aneurysm.