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P491: MICROSURGICAL CLIPPING OF A RECURRENT RIGHT MCA ANEURYSM AFTER WEB EMBOLIZATION
Daniele Starnoni; Danielle Golub; Amir R Dehdashti; Northwell Health

This video demonstrates the microsurgical clipping of a recurrent middle cerebral artery aneurysm previously treated with a WEB device. A 51-year-old woman initially presented with subarachnoid hemorrhage from a ruptured right ophthalmic aneurysm. A 7 mm MCA bifurcation aneurysm was treated simultaneously with WEB. Follow-up imaging showed progressive recurrence. Standard pterional approach was used for clipping. Intraoperative ICG confirmed exclusion. Histological analysis revealed WEB remnants. The patient had no postoperative complications or new neurological deficits.

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