A technique of clipping giant intracranial aneurysms with the preservation of the parent artery

Several methods are currently available for the treatment of giant intracranial aneurysms. In this report, we emphasize the technique of temporary trapping of the aneurysm followed by aspiration and collapse, and subsequent clipping. This method permits the preservation of the parent vessel and avoids the need for creating a microvascular bypass. Two cases are presented to illustrate this technique; in one case the patient had a giant middle cerebral artery aneurysm, and in the other a giant carotid-ophthalmic artery aneurysm. Both aneurysms were successfully clipped with preservation of the major vessels and a good result. On the basis of the configurations of their necks, giant aneurysms can be classified into three groups. The different methods of treating these aneurysms are reviewed with respect to this classification.