Surgical treatment of internal carotid and posterior communicating artery aneurysms

Saccular aneurysms of the subarachnoid segment of the internal carotid artery (ICA) are very common. Although some of the aneurysms arising from the subarachnoid ICA have earned the reputation of easy to treat surgically, aneurysms in this region may be complex and quite difficult to repair. Even a simple aneurysm associated with the posterior communicating artery may harbor surprises for the unwary or inexperienced surgeon. This article details the pertinent anatomy of the subarachnoid internal carotid artery and associated saccular aneurysms, provides a guide to their diagnosis and surgical treatment, and briefly reviews some of the published surgical results. Pitfalls and technique tips are highlighted.