Tasuki clipping combined with high flow bypass for ruptured, previously coiled, partially thrombosed giant aneurysm at the carotid bifurcation

Abstract

A 33-year-old woman presented with a ruptured, partially thrombosed carotid bifurcation aneurysm after partial coiling, which was successfully treated by "tasuki" (a cloth sash crossing from one shoulder to the opposite hip, worn by relay marathon runners) clipping combined with radial artery and external carotid artery-to-middle cerebral artery bypass. "Tasuki" clipping can overcome the dilemma between achieving early complete thrombosis in the blind sac andmaintaining anterograde flow of the parent artery to prevent inadvertent occlusion of the perforators and anterior choroidal artery.