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Flow recovery after posterior clinoidectomy for surgical clipping of anterior choroidal aneurysm
Federico Carlos Gallardo,Juan Santiago Bottan,Clara Martin,Aylen Andrea Targa Carcia,Roman Pablo Arevalo,Pablo Augusto Rubino 대한뇌혈관외과학회 2021 Journal of Cerebrovascular and Endovascular Neuros Vol.23 No.4
Inadvertent flow alterations in the parent artery during microsurgical clipping might produce postoperative ischemic complications. Intraoperative recognition of such alterations and its correction might improve operative outcomes in these patients. We present the case of a thirty-five-year-old male with an incidental small left anterior choroidal aneurysm. Microsurgical clipping induced an external compression of the anterior choroidal artery against the posterior clinoidal process which was identified in situ through surgical exploration and the loss of arterial doppler signal in the vessel. After failed attempts at clip repositioning, a posterior clinoidectomy was performed to decompress the artery. This resulted in arterial flow recovery. The aneurysm was successfully treated, and a severe ischemic complication was likely avoided. This intraoperative phenomenon has not yet been described in the literature.