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Objective The aim of the study was to explore the values and disadvantages of micromirror in the intracranial aneurysm clipping surgery. Methods Micromirror was used to assist microsurgical clipping to 36 intracranial aneurysms in 31 patients, of which 3 were carotid-ophthalmic artery aneurysms, 3 were anterior choroidal artery aneurysms, 11 were posterior communicating artery aneurysms, 7 were middle cerebral artery aneurysms, 10 were anterior communicating artery or anterior cerebral artery aneurysms, and the rest were a posterior cerebral artery aneurysm and a posterior inferior cerebellar artery aneurysm. The micromirror was used before and after clipping to observe the anatomic features of necks hidden behind and medial to aneurysms, to visualize surrounding neurovascular structures, and to verify the optimal clipping position. Intraoperative indocyanine green fluorescein angiography, postoperative computerized tomography angiography, and digital subtraction angiography confirmed the success of sufficient clipping. Results Intraoperative indocyanine green angiography, postoperative computerized tomography angiography , or digital subtraction angiography were performed and showed no case of wrong or insufficient clipping of aneurysm. Conclusions Micromirror-assisted microsurgical clipping to the intracranial aneurysm is safe, sufficient, convenient, and practical.

The true posterior communicating artery (PCoA) aneurysms in the distal portion of the posterior communicating artery are rare. The authors describe a 63-year-old woman with 1 true PCoA aneurysms in the distal portion of the PCoA, which was treated surgically through modified pterional approach. No neurologic deficit was present at the postoperative period. Although endovascular intervention is more and more widely used in the treatment of aneurysms, the authors have also emphasized that true PCoA aneurysms in the distal portion of the PCoA can also be surgically treated in suitable patients.