Department of Neurosurgery, Mizonokuchi Hospital, Teikyo University, School of Medicine, Kawasaki, Japan; Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, Hidaka, Japan. Electronic address: [Email]
Treatment of complex unruptured middle cerebral artery (MCA) aneurysms that are untreatable with conventional surgical techniques are rare, and direct aneurysmal clipping usually remains the first-line treatment for large and giant saccular MCA aneurysms. Tandem clipping and multiple clipping techniques represent neck reconstruction in direct clipping surgeries that address these aneurysms.