Suction decompression during anterior clinoidectomy for direct clipping of paraclinoid aneurysm involving the anterior clinoid process

Surgical clipping of paraclinoid aneurysms involving the anterior clinoid process (ACP) can present great challenges because strong adhesion may hinder dissection of the surrounding anatomical structures from the aneurysm dome. On the other hand, retrograde suction decompression (RSD) through direct puncture of the common carotid artery is a useful adjunct technique for clipping of these aneurysms. The present case illustrates that direct clipping of paraclinoid aneurysms involving the ACP can be achieved safely and less invasively using RSD during anterior clinoidectomy. Postoperatively, her clinical course was uneventful. RSD is a useful technique during anterior clinoidectomy in direct clipping of paraclinoid aneurysms involving the ACP.