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. 2013 Dec 27;54(3):180–188. doi: 10.2176/nmc.oa.2013-0001

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© 2014 The Japan Neurosurgical Society

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/

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Fig. 2 — A: 3D-CTA demonstrated a thrombosed giant aneurysm (40 mm) at the M1 portion of the right MCA. B: A thrombosed giant aneurysm (40 mm) at the M1 portion of the right MCA after STA-M2 double anastomosis was shown schematically. C: A vasorecontructive M1 with part of the incised aneurysmal wall using 6-0 Proline was illustrated. D: After trapping and reopening of the M1 segment, thrombus formation within the vessel was verified (intraoperative photograph). E: After trapping and removal of the M1 segment, recirculation of blood flow in the perforating artery at the distal portion of the M1 was shown schematically. F, G: Postoperative magnetic resonance imaging revealed a fresh infarction in the right lenticulostriate artery territory and 3D-CTA showed removal of the giant aneurysm and bypass patency. IC: internal carotid, LSA: lenticulostriate artery, MCA: middle cerebral artery, PcomA: posterior communicating artery, STA: superficial temporal artery, 3D-CTA: three dimensional-computerized tomography angiography.