How I do it? Basilar bifurcation and left anterior choroidal artery aneurysms clipping.

[BACKGROUND] Despite advancements in endovascular techniques, microsurgical treatment for posterior circulation aneurysms remains challenging.

[METHOD] This report highlights the successful clipping surgery of a 17-year-old female patient with an aneurysm located at the basilar artery (BA) bifurcation and left anterior choroidal artery (AChoA). To improve exposure, the posterior communicating artery was transected. A straight fenestrated clip was then placed to repair the BA bifurcation aneurysm, followed by a curved mini clip for the AChoA aneurysm.

[CONCLUSION] This report demonstrates the nuances of microsurgery in the treatment of select complex cases, which can benefit from microsurgery to achieve optimal treatment outcomes.