Complex Aneurysm of Junction of Posterior Cerebral and Posterior Communicating Artery: A Case Report and Review of Treatment Options

Intracranial aneurysms with a wide neck and incorporated arterial branches remain difficult to treat, despite the advances of techniques and materials used. If such a complex aneurysm arises in posterior circulation, a microsurgical procedure may be associated with high risk of complications, and the aneurysm is usually more suitable for endovascular treatment with neck remodeling by a balloon or a stent. We present the use of neck remodeling by microcatheter and microguidewire in a patient with a wide-neck aneurysm that involved the junction of left posterior communicating artery and a fetal-type posterior cerebral artery. This technique may be useful in cases with complicated anatomy where the traditional use of stent or a balloon carries a high risk of aneurysm perforation due to the acute angle of vessels at the aneurysm neck.