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We describe intracranial bypass options employed in direct clipping of the large cerebral aneurysm. The bypass techniques used included STA-MCA bypass (n=2), radial artery graft (n=2), ACA-ACA side to side (n=1), and STA-PCA, STA-SCA bypass (n=1). We consider the options of vascular reconstruction prior to manipulation of the aneurysm when the patency of the parent artery is unpredictable.
