ICA aneurysm surgically treated utilizing a choroidal to PCOM bypass and vein bypass

Nirav J. Patel, and Michael K. Morgan, M.D. This video shows the surgical repair of a 2.3 cm ICA aneurysm found in a 58 year old woman, who presented for right eye vision changes. The patient underwent a right modified orbito-zygomatic craniotomy and saphenous vein bypass from the common carotid to the temporal M2. The aneurysm was then opened and repaired. However, since the anterior choroidal artery was not filling, a salvage bypass between the anterior choroidal and the PCOM was done. Both bypasses were patent and the patient has done well with a mRS of 1 for vision symptoms.