Endaneurysmal microendarterectomy in the treatment of giant cerebral aneurysms: technical note

Giant cerebral aneurysms continue to present the surgeon with substantial technical challenges. Operative techniques for managing giant cerebral aneurysms are becoming increasingly sophisticated. We emphasize in this report a technique for direct obliteration of the giant aneurysm with a hard, calcified atheroma at its base that prevents direct clip application without compromise of the parent artery. Temporary trapping of the aneurysm, intramural thrombectomy, and endaneurysmal microendarterectomy allow direct obliteration of the aneurysm neck with preservation of the parent artery.