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Updated: Jan 21, 2026

Microsurgical Venous Pouch Arterial-Bifurcation Aneurysms in the Rabbit Model: Technical Aspects
Published on: May 11, 2011
Contralateral approach for the treatment of a distal supraclinoid aneurysm: a technical case report
Eric S Nussbaum1, Kevin M Kallmes2
1Department of Neurosurgery, National Brain Aneurysm & Tumor Center, United Hospital, St. Paul, MN, USA.
Background:
When treating intracranial aneurysms with open microsurgery, rare cases arise in which an ipsilateral approach leads to poor visualization, lack of proximal control, or potential damage to nearby vital structures due to the anatomy of the aneurysm.
Case Description:
We describe a patient with a small, unruptured aneurysm arising from the medial aspect of the distal supraclinoid internal carotid artery (ICA), just below the ICA bifurcation. A contralateral surgical approach was chosen because our view of the aneurysm from an ipsilateral approach would have been obstructed by the ICA. The contralateral approach provided excellent exposure of the aneurysm and allowed for precise clip placement without complications.
Conclusions:
Contralateral approaches may be a good option for some small medially pointing aneurysm of large proximal cerebral arteries.
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