A 3D RA image from Philips FD2010 Angiography machine showing a large bilobed posterior communicating artery aneurysm in which the the posterior cerebral artery seems to arise from the aneurysm itself. This is a very challenging aneurysm for an endosvascular treatment since if the aneurysm was coiled, it would sacrifice the posterior cerebral artery. Another option is to stent the posterior cerebral artery and then coil the aneurysm. After discussions, the best option is to clip the aneurysm until the origin of the posterior cerebral artery by neurovascular surgeon.
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