Microsurgical clipping of aneurysms of the right middle cerebral artery bifurcation, ophthalmic segment of right internal carotid artery using of MIPLATTA approach: a video case report

Microsurgical clipping of aneurysms of the bifurcation of the middle cerebral artery (MCA) and the ophthalmic segment of the internal carotid artery (ICA) requires precise access and minimization of the risk of damage to structures. This video case presents successful clipping of a multiple aneurysm of the above segments using a combined Minimally Invasive Posterolateral Transcavernous Transtentorial Approach (MIPLATTA). A 45-year-old female was admitted with complaints of long-term headache in the occipital and temporal regions, which had been bothering her for 20 years. Computed tomography (CT) angiography revealed saccular aneurysms of the M1-M2 segments of the right MCA and the ophthalmic segment of the right ICA. Complete clipping of the MCA aneurysm was performed, then the ICA aneurysm. Postoperative CT angiography did not reveal any signs of contrasting of the aneurysm necks. The use of MIPLATTA, due to the visualization of important anatomical structures and complete proximal and distal control of the ICA, allows for radical exclusion of aneurysms from the bloodstream without complications. © 2025, I.M. Sechenov First Moscow State Medical University. All rights reserved.