High-flow bypass surgery for a large cavernous internal carotid artery aneurysm associated with persistent primitive trigeminal artery: A case report
Year: 2026
Type: article
Study design: Case Report
Abstract: Background: Giant cavernous internal carotid artery (ICA) aneurysms present with therapeutic challenges, especially if associated with a persistent primitive trigeminal artery (PPTA). Although flow diverters (FDs) are commonly used, the PPTA can maintain collateral inflow to the aneurysm sac, preventing complete thrombosis. Case Description: A 74-year-old woman presented with progressive oculomotor nerve palsy and visual decline. High-flow external carotid-middle cerebral artery bypass with distal ICA occlusion beyond the aneurysm was performed. The bypass remained patent without infarction, and partial aneurysm thrombosis occurred, whereas PPTA flow was preserved. Conclusion: This case emphasizes the importance of individual microsurgical strategies if FD treatment may be ineffective due to complex embryonic vascular anatomy.
Source: Surgical Neurology International
Authors: Yu Otaki, Tatsuya Shimizu
Institution: Maebashi Red Cross Hospital
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7127977026