Matricidal carotid cavernous aneurysm (CCA) is a rare and dangerous condition. The treatment failure of the endovascular approach like flow diversion, coiling, or stent-coiling is relatively high with considerable morbidity and mortality. The transcirculation approach is an alternative treatment option, but in case of matricidal CCAs, the results are not well documented in the literature. The authors present a complicated case of an unsuccessful transcirculation approach for matricidal CCA finally treated with sacrifice of the parent artery and high-flow bypass.

Department of Neurosurgery and Neurooncology 1st Faculty of Medicine Military University Hospital and Charles University Prague Czech Republic

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Dacus MR, Nickele C, Welch BG, Ban VS, Ringer AJ, Kim LJ, et al. . Matricidal cavernous aneurysms: a multicenter case series. J Neurointerv Surg. 2019;11(6):584–90. 10.1136/neurintsurg-2018-014562. PubMed DOI

International Study of Unruptured Intracranial Aneurysms Investigators . Unruptured intracranial aneurysms: risk of rupture and risks of surgical intervention. N Engl J Med. 1998;339(24):1725–33. 10.1056/NEJM199812103392401. PubMed DOI

Goldenberg-Cohen N, Curry C, Miller NR, Tamargo RJ, Murphy KPJ. Long term visual and neurological prognosis in patients with treated and untreated cavernous sinus aneurysms. J Neurol Neurosurg Psychiatry. 2004;75(6):863–7. 10.1136/jnnp.2003.020917. PubMed DOI PMC

Stiebel-Kalish H, Kalish Y, Bar-On RH, Setton A, Niimi Y, Berenstein A, et al. . Presentation, natural history, and management of carotid cavernous aneurysms. Neurosurgery. 2005;57(5):850–7; discussion 850-7. 10.1227/01.neu.0000179922.48165.42. PubMed DOI

Raper DM, Ding D, Peterson EC, Crowley RW, Liu KC, Chalouhi N, et al. . Cavernous carotid aneurysms: a new treatment paradigm in the era of flow diversion. Expert Rev Neurother. 2017;17(2):155–63. 10.1080/14737175.2016.1212661. PubMed DOI

Miyachi S, Hiramatsu R, Ohnishi H, Yagi R, Kuroiwa T. Usefulness of the pipeline embolic device for large and giant carotid cavernous aneurysms. Neurointervention. 2017;12(2):83–90. 10.5469/neuroint.2017.12.2.83. PubMed DOI PMC

Miyachi S, Ohnishi H, Hiramatsu R, Izumi T, Matsubara N, Kuroiwa T. Innovations in endovascular treatment strategies for large carotid cavernous aneurysms-the safety and efficacy of a flow diverter. J Stroke Cerebrovasc Dis. 2017;26(5):1071–80. 10.1016/j.jstrokecerebrovasdis.2016.12.023. PubMed DOI

Goyal N, Hoit D, DiNitto J, Elijovich L, Fiorella D, Pierot L, et al. . How to WEB: a practical review of methodology for the use of the Woven EndoBridge. J Neurointerv Surg. 2020;12(5):512–20. 10.1136/neurintsurg-2019-015506. PubMed DOI PMC