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P365: MICROSURGICAL MANAGEMENT OF A COMPLEX MCA BIFURCATION ANEURYSM WITH M2-M2 BYPASS AND CLIP RECONSTRUCTION
Ali A Alattar; Georgios A Zenonos, MD; University of Pittsburgh Medical Center

This video demonstrates microsurgical management of a complex, dysplastic right MCA bifurcation aneurysm. After frontotemporal craniotomy and Sylvian fissure dissection, an bypass was performed using an M2–M2 side-to-side anastomosis to secure distal flow. The aneurysm was then obliterated with a “picket fence” of fenestrated clips. Intraoperative angiography and Doppler confirmed bypass patency and flow preservation. The patient remained neurologically intact and was discharged on postoperative day three

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