Endovascular pulmonary artery inflatable balloon-induced hyp
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A 50-year old female patient presented with a progressive visual loss in both her eyes of 2-month duration. On evaluation, she had a perception of light only in the right eye, with 6/18 vision in the left eye. Magnetic resonance imaging (MRI) of the brain and subsequently, her computed tomography (CT) angiography revealed a giant aneurysm of a left A1 segment of the anterior cerebral artery (ACA) without any thrombus, that was projecting inferiorly and causing compression of both the optic nerves and chiasm. A diagnosis of giant unruptured left A1 segment aneurysm was made and different treatment options were considered. In view of the optic nerve compression with gross visual defects, surgical obliteration was preferred over endovascular coiling. Due to the inferior projection of an aneurysm, it was considered surgically difficult to gain control over the contralateral A1 segment of the ACA. Authors induced hypotension for clipping a giant aneurysm by using an inflatable balloon across the main pulmonary artery with a successful outcome.

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