• Jean A Eloy, Andrea Carai, Aman B Patel, Eric M Genden, and Joshua B Bederson.
• Department of Otolaryngology, Head and Neck Surgery, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1189, New York, NY 10029, USA. Jean.Anderson.Eloy@gmail.com
• Neurosurgery. 2008 Mar 1; 62 (3 Suppl 1): 142144142-3; discussion 143-4.

ObjectiveWe describe a patient with a mid-basilar aneurysm treated with combined endoscope-assisted transsphenoidal clipping and endovascular stenting.Clinical PresentationA 28-year-old woman was transferred to the cranial base surgery center with an acute Grade III subarachnoid hemorrhage. Cerebral angiography demonstrated a small basilar trunk aneurysm that was not amenable to acute endovascular treatment.InterventionThe patient underwent sublabial transsphenoidal/transclival endoscope-assisted clipping of the aneurysm and subsequent stenting of the affected segment. The aneurysm was repaired with a low-profile Weck clip (Weck Closure Systems Research, Triangle Park, NC) that permitted a watertight closure of the clival dura using cardiac Medtronic U-clips (Medtronic, Inc., Minneapolis, MN). Postoperatively, the patient had no evidence of cerebrospinal fluid leakage.ConclusionWatertight dural closure was possible due to the use of a low-profile aneurysm clip that did not protrude through the dural defect, as well as self-tying sutures.

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