{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:51:59Z","timestamp":1769727119950,"version":"3.49.0"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"16","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,10,14]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Paraclinoid aneurysms can pose an operative challenge during clip reconstruction, given the complex surrounding anatomy and the aneurysmal tendency to maintain turgor despite standard approaches to proximal control. This report demonstrates the use of intraoperative retrograde arteriovenous shunting with the transcarotid artery revascularization (TCAR) system to assist in the safe clip reconstruction of an irregular paraclinoid aneurysm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 33-year-old woman presented with perimesencephalic subarachnoid hemorrhage and was found to have an incidental 9-mm ophthalmic aneurysm. Coil embolization was not successful. During microsurgical clip reconstruction, the left common carotid artery was exposed to allow for proximal control as well as transcarotid arterial sheath placement. Flow reversal was instituted throughout the aneurysm dissection and clipping, with a visible softening of the aneurysm. Intraoperative angiography confirming successful clip reconstruction was performed utilizing the TCAR sheath. The case was complicated by the development of cerebrospinal fluid rhinorrhea postoperatively, requiring surgical repair. The patient has since made a complete recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Transcarotid flow reversal utilizing the TCAR system has potential for use in the surgical treatment of paraclinoid aneurysms, as it may aid in softening the aneurysm for safer dissection and clip reconstruction, protect against aneurysm-associated emboli, and provide an avenue for intraoperative angiography.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24330\">https:\/\/thejns.org\/doi\/10.3171\/CASE24330<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24330","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T02:44:49Z","timestamp":1728873889000},"source":"Crossref","is-referenced-by-count":0,"title":["Transcarotid flow reversal for proximal control during cerebral aneurysm clip reconstruction: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Nicole M","family":"Wenger","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Hentschel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting I","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin T","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Caffes","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Cherian","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"9","key":"bib1","series-title":"J Neurol Neurosurg Psychiatry","first-page":"837","article-title":"Carotid-ophthalmic aneurysms","volume":"39","author":"Sengupta","year":"1976","unstructured":"Sengupta RPGryspeerdt GLHankinson J. Carotid-ophthalmic aneurysms. J Neurol Neurosurg Psychiatry. 1976;39(9):837-853."},{"issue":"1","key":"bib2","series-title":"J Clin Neurosci","first-page":"13","article-title":"Paraclinoid carotid aneurysms","volume":"18","author":"Javalkar","year":"2011","unstructured":"Javalkar VBanerjee ADNanda A. Paraclinoid carotid aneurysms. J Clin Neurosci. 2011;18(1):13-22."},{"issue":"4","key":"bib3","series-title":"J Neurosurg","first-page":"438","article-title":"Management of carotid-ophthalmic aneurysms","volume":"42","author":"Guidetti","year":"1975","unstructured":"Guidetti BLa Torre E. Management of carotid-ophthalmic aneurysms. J Neurosurg. 1975;42(4):438-442."},{"issue":"4","key":"bib4","series-title":"Acta Neurochir (Wien)","first-page":"289","article-title":"Carotid-ophthalmic aneurysms. A series of 16 cases treated by direct approach","volume":"22","author":"Guidetti","year":"1970","unstructured":"Guidetti BLa Torre E. Carotid-ophthalmic aneurysms. A series of 16 cases treated by direct approach. Acta Neurochir (Wien). 1970;22(4):289-304."},{"issue":"1","key":"bib5","series-title":"J Neurosurg","first-page":"24","article-title":"Carotid-ophthalmic aneurysms","volume":"29","author":"Drake","year":"1968","unstructured":"Drake CGVanderlinden RGAmacher AL. Carotid-ophthalmic aneurysms. J Neurosurg. 1968;29(1):24-31."},{"issue":"2","key":"bib6","series-title":"J Neurosurg","first-page":"275","article-title":"Suction decompression of aneurysms. Technical note","volume":"54","author":"Flamm","year":"1981","unstructured":"Flamm ES. Suction decompression of aneurysms. Technical note. J Neurosurg. 1981;54(2):275-276."},{"issue":"2","key":"bib7","series-title":"J Neurosurg","first-page":"305","article-title":"Retrograde suction decompression of giant paraclinoidal aneurysms. Technical note","volume":"73","author":"Batjer","year":"1990","unstructured":"Batjer HHSamson DS. Retrograde suction decompression of giant paraclinoidal aneurysms. Technical note. J Neurosurg. 1990;73(2):305-306."},{"issue":"4","key":"bib8","series-title":"J Neurosurg","first-page":"650","article-title":"Surgery for paraclinoidal carotid artery aneurysms","volume":"80","author":"Batjer","year":"1994","unstructured":"Batjer HHKopitnik TAGiller CASamson DS. Surgery for paraclinoidal carotid artery aneurysms. J Neurosurg. 1994;80(4):650-658."},{"issue":"1","key":"bib9","series-title":"J Neurosurg","first-page":"146","article-title":"Retrograde suction decompression of an ophthalmic artery aneurysm using balloon occlusion. Technical note","volume":"75","author":"Scott","year":"1991","unstructured":"Scott JAHorner TGLeipzig TJ. Retrograde suction decompression of an ophthalmic artery aneurysm using balloon occlusion. Technical note. J Neurosurg. 1991;75(1):146-147."},{"issue":"12","key":"bib10","series-title":"Chin Med J (Engl)","first-page":"1061","article-title":"Surgical management of large and giant intracavernous and paraclinoid aneurysms","volume":"121","author":"Xu","year":"2008","unstructured":"Xu BNSun ZHJiang JL, et al. Surgical management of large and giant intracavernous and paraclinoid aneurysms. Chin Med J (Engl). 2008;121(12):1061-1064."},{"issue":"3","key":"bib11","series-title":"World Neurosurg","first-page":"137","article-title":"Microsurgical management of large and giant paraclinoid aneurysms","volume":"73","author":"Xu","year":"2010","unstructured":"Xu BNSun ZHRomani R, et al. Microsurgical management of large and giant paraclinoid aneurysms. World Neurosurg. 2010;73(3):137-146."},{"key":"bib12","series-title":"J Clin Neurosci","first-page":"264","article-title":"Microsurgical treatment of large and giant paraclinoid carotid aneurysms using a revised endovascular suction decompression technique with Invatec Mo.Ma device","volume":"33","author":"Gao","year":"2016","unstructured":"Gao XYu CWang X, et al. Microsurgical treatment of large and giant paraclinoid carotid aneurysms using a revised endovascular suction decompression technique with Invatec Mo.Ma device. J Clin Neurosci. 2016;33:264-268."},{"issue":"3","key":"bib13","series-title":"J Vasc Surg","first-page":"916","article-title":"Technical aspects of transcarotid artery revascularization using the enroute transcarotid neuroprotection and stent system","volume":"65","author":"Malas","year":"2017","unstructured":"Malas MBLeal JKashyap VCambria RPKwolek CJCriado E. Technical aspects of transcarotid artery revascularization using the enroute transcarotid neuroprotection and stent system. J Vasc Surg. 2017;65(3):916-920."},{"issue":"2","key":"bib14","series-title":"J Vasc Surg","first-page":"572","article-title":"In-hospital and one-year outcomes are similar for women and men following transcarotid artery revascularization in symptomatic and asymptomatic patients","volume":"75","author":"Deery","year":"2022","unstructured":"Deery SEHolscher CMNejim B, et al. In-hospital and one-year outcomes are similar for women and men following transcarotid artery revascularization in symptomatic and asymptomatic patients. J Vasc Surg. 2022;75(2):572-580.e3."},{"issue":"8","key":"bib15","series-title":"J Neurointerv Surg","first-page":"842","article-title":"Transcarotid artery revascularization (TCAR): a technical video","volume":"14","author":"Sujijantarat","year":"2022","unstructured":"Sujijantarat NAntonios JKoo A, et al. Transcarotid artery revascularization (TCAR): a technical video. J Neurointerv Surg. 2022;14(8):842."},{"issue":"1","key":"bib16","series-title":"Sci Rep","first-page":"3507","article-title":"Precise MEP monitoring with a reduced interval is safe and useful for detecting permissive duration for temporary clipping","volume":"10","author":"Kameda","year":"2020","unstructured":"Kameda MHishikawa THiramatsu MYasuhara TKurozumi KDate I. Precise MEP monitoring with a reduced interval is safe and useful for detecting permissive duration for temporary clipping. Sci Rep. 2020;10(1):3507."},{"issue":"2","key":"bib17","series-title":"Asian J Neurosurg","first-page":"237","article-title":"Optimal use of temporary clip application during aneurysm surgery\u2014in search of the Holy Grail","volume":"16","author":"Kumar","year":"2021","unstructured":"Kumar SSahana DMenon G. Optimal use of temporary clip application during aneurysm surgery\u2014in search of the Holy Grail. Asian J Neurosurg. 2021;16(2):237-242."},{"issue":"6","key":"bib18","series-title":"J Neurosurg","first-page":"817","article-title":"Temporary occlusion of the middle cerebral artery in intracranial aneurysm surgery: time limitation and advantage of brain protection","volume":"87","author":"Lavine","year":"1997","unstructured":"Lavine SDMasri LSLevy MLGiannotta SL. Temporary occlusion of the middle cerebral artery in intracranial aneurysm surgery: time limitation and advantage of brain protection. J Neurosurg. 1997;87(6):817-824."},{"issue":"5","key":"bib19","series-title":"J Neurosurg","first-page":"785","article-title":"Temporary vessel occlusion for aneurysm surgery: risk factors for stroke in patients protected by induced hypothermia and hypertension and intravenous mannitol administration","volume":"84","author":"Ogilvy","year":"1996","unstructured":"Ogilvy CSCarter BSKaplan SRich CCrowell RM. Temporary vessel occlusion for aneurysm surgery: risk factors for stroke in patients protected by induced hypothermia and hypertension and intravenous mannitol administration. J Neurosurg. 1996;84(5):785-791."},{"key":"bib20","series-title":"Surg Neurol Int","first-page":"79","article-title":"Safe time duration for temporary middle cerebral artery occlusion in aneurysm surgery based on motor-evoked potential monitoring","volume":"8","author":"Tanabe","year":"2017","unstructured":"Tanabe JIshikawa TMoroi J. Safe time duration for temporary middle cerebral artery occlusion in aneurysm surgery based on motor-evoked potential monitoring. Surg Neurol Int. 2017;8:79."},{"issue":"2","key":"bib21","series-title":"J Vasc Surg","first-page":"584","article-title":"Duration of blood flow reversal during transcarotid artery revascularization does not affect outcome","volume":"72","author":"Kumins","year":"2020","unstructured":"Kumins NHKing AHJim J, et al. Duration of blood flow reversal during transcarotid artery revascularization does not affect outcome. J Vasc Surg. 2020;72(2):584-588."},{"issue":"2","key":"bib22","series-title":"J Endovasc Ther","first-page":"265","article-title":"Transcarotid artery revascularization with flow reversal","volume":"24","author":"Alpaslan","year":"2017","unstructured":"Alpaslan AWintermark MPint\u00e9r LMacdonald SRuedy RKolvenbach R. Transcarotid artery revascularization with flow reversal. J Endovasc Ther. 2017;24(2):265-270."},{"key":"bib23","series-title":"Ann Vasc Surg","first-page":"11","article-title":"Impact of flow reversal duration on neurological outcomes of transcarotid artery revascularization (TCAR)","volume":"89","author":"Naazie","year":"2023","unstructured":"Naazie INDodo-Williams TJanssen CLane JSmeds MRMalas M. Impact of flow reversal duration on neurological outcomes of transcarotid artery revascularization (TCAR). Ann Vasc Surg. 2023;89:11-19."},{"key":"bib24","series-title":"Clin Neurosurg","first-page":"248","article-title":"Microsurgical anatomy of common aneurysm sites","volume":"26","author":"Rhoton","year":"1979","unstructured":"Rhoton ALJrSaeki NPerlmutter DZeal A. Microsurgical anatomy of common aneurysm sites. Clin Neurosurg. 1979;26:248-306."},{"key":"bib25","series-title":"Rhoton Cranial Anatomy and Surgical Approaches","author":"Rhoton","year":"2020","unstructured":"Rhoton AL. Rhoton Cranial Anatomy and Surgical Approaches. Oxford University Press; 2020."},{"key":"bib26","article-title":"501(k) Summary for enroute transcarotid neuroprotection system","unstructured":"Administration. 501(k) Summary for enroute transcarotid neuroprotection system. Accessed October 11, 2023. https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf23\/K230402.pdf"},{"issue":"5","key":"bib27","series-title":"Interv Neuroradiol","first-page":"580","article-title":"Intra-aneurysmal microcatheter looping technique for stent-assisted embolization of complex intracranial aneurysms","volume":"21","author":"Wang","year":"2015","unstructured":"Wang CCLv NFeng ZZ, et al. Intra-aneurysmal microcatheter looping technique for stent-assisted embolization of complex intracranial aneurysms. Interv Neuroradiol. 2015;21(5):580-584."},{"issue":"1","key":"bib28","series-title":"Oper Neurosurg (Hagerstown)","first-page":"E39","article-title":"Distal access to wide-necked aneurysms\u2014\u2018around the world\u2019 technique: 2-dimensional operative video","volume":"20","author":"Ringer","year":"2020","unstructured":"Ringer AJ, Endovascular Neurosurgery Research Group (ENRG). Distal access to wide-necked aneurysms\u2014\u2018around the world\u2019 technique: 2-dimensional operative video. Oper Neurosurg (Hagerstown). 2020;20(1):E39-E40."},{"key":"bib29","series-title":"J Neurointerv Surg","author":"Sujijantarat","year":"2024","unstructured":"Sujijantarat NRenedo DAntonios J, et al. Use of a dedicated open transcarotid access system for neurovascular disease. J Neurointerv Surg. 2024. Published online May 6, 2024. doi:10.1136\/jnis-2024-02159"},{"issue":"9","key":"bib1","series-title":"J Neurol Neurosurg Psychiatry","first-page":"837","article-title":"Carotid-ophthalmic aneurysms","volume":"39","author":"Sengupta","year":"1976","unstructured":"Sengupta RPGryspeerdt GLHankinson J. Carotid-ophthalmic aneurysms. J Neurol Neurosurg Psychiatry. 1976;39(9):837-853."},{"issue":"1","key":"bib2","series-title":"J Clin Neurosci","first-page":"13","article-title":"Paraclinoid carotid aneurysms","volume":"18","author":"Javalkar","year":"2011","unstructured":"Javalkar VBanerjee ADNanda A. Paraclinoid carotid aneurysms. J Clin Neurosci. 2011;18(1):13-22."},{"issue":"4","key":"bib3","series-title":"J Neurosurg","first-page":"438","article-title":"Management of carotid-ophthalmic aneurysms","volume":"42","author":"Guidetti","year":"1975","unstructured":"Guidetti BLa Torre E. Management of carotid-ophthalmic aneurysms. J Neurosurg. 1975;42(4):438-442."},{"issue":"4","key":"bib4","series-title":"Acta Neurochir (Wien)","first-page":"289","article-title":"Carotid-ophthalmic aneurysms. A series of 16 cases treated by direct approach","volume":"22","author":"Guidetti","year":"1970","unstructured":"Guidetti BLa Torre E. Carotid-ophthalmic aneurysms. A series of 16 cases treated by direct approach. Acta Neurochir (Wien). 1970;22(4):289-304."},{"issue":"1","key":"bib5","series-title":"J Neurosurg","first-page":"24","article-title":"Carotid-ophthalmic aneurysms","volume":"29","author":"Drake","year":"1968","unstructured":"Drake CGVanderlinden RGAmacher AL. Carotid-ophthalmic aneurysms. J Neurosurg. 1968;29(1):24-31."},{"issue":"2","key":"bib6","series-title":"J Neurosurg","first-page":"275","article-title":"Suction decompression of aneurysms. Technical note","volume":"54","author":"Flamm","year":"1981","unstructured":"Flamm ES. Suction decompression of aneurysms. Technical note. J Neurosurg. 1981;54(2):275-276."},{"issue":"2","key":"bib7","series-title":"J Neurosurg","first-page":"305","article-title":"Retrograde suction decompression of giant paraclinoidal aneurysms. Technical note","volume":"73","author":"Batjer","year":"1990","unstructured":"Batjer HHSamson DS. Retrograde suction decompression of giant paraclinoidal aneurysms. Technical note. J Neurosurg. 1990;73(2):305-306."},{"issue":"4","key":"bib8","series-title":"J Neurosurg","first-page":"650","article-title":"Surgery for paraclinoidal carotid artery aneurysms","volume":"80","author":"Batjer","year":"1994","unstructured":"Batjer HHKopitnik TAGiller CASamson DS. Surgery for paraclinoidal carotid artery aneurysms. J Neurosurg. 1994;80(4):650-658."},{"issue":"1","key":"bib9","series-title":"J Neurosurg","first-page":"146","article-title":"Retrograde suction decompression of an ophthalmic artery aneurysm using balloon occlusion. Technical note","volume":"75","author":"Scott","year":"1991","unstructured":"Scott JAHorner TGLeipzig TJ. Retrograde suction decompression of an ophthalmic artery aneurysm using balloon occlusion. Technical note. J Neurosurg. 1991;75(1):146-147."},{"issue":"12","key":"bib10","series-title":"Chin Med J (Engl)","first-page":"1061","article-title":"Surgical management of large and giant intracavernous and paraclinoid aneurysms","volume":"121","author":"Xu","year":"2008","unstructured":"Xu BNSun ZHJiang JL, et al. Surgical management of large and giant intracavernous and paraclinoid aneurysms. Chin Med J (Engl). 2008;121(12):1061-1064."},{"issue":"3","key":"bib11","series-title":"World Neurosurg","first-page":"137","article-title":"Microsurgical management of large and giant paraclinoid aneurysms","volume":"73","author":"Xu","year":"2010","unstructured":"Xu BNSun ZHRomani R, et al. Microsurgical management of large and giant paraclinoid aneurysms. World Neurosurg. 2010;73(3):137-146."},{"key":"bib12","series-title":"J Clin Neurosci","first-page":"264","article-title":"Microsurgical treatment of large and giant paraclinoid carotid aneurysms using a revised endovascular suction decompression technique with Invatec Mo.Ma device","volume":"33","author":"Gao","year":"2016","unstructured":"Gao XYu CWang X, et al. Microsurgical treatment of large and giant paraclinoid carotid aneurysms using a revised endovascular suction decompression technique with Invatec Mo.Ma device. J Clin Neurosci. 2016;33:264-268."},{"issue":"3","key":"bib13","series-title":"J Vasc Surg","first-page":"916","article-title":"Technical aspects of transcarotid artery revascularization using the enroute transcarotid neuroprotection and stent system","volume":"65","author":"Malas","year":"2017","unstructured":"Malas MBLeal JKashyap VCambria RPKwolek CJCriado E. Technical aspects of transcarotid artery revascularization using the enroute transcarotid neuroprotection and stent system. J Vasc Surg. 2017;65(3):916-920."},{"issue":"2","key":"bib14","series-title":"J Vasc Surg","first-page":"572","article-title":"In-hospital and one-year outcomes are similar for women and men following transcarotid artery revascularization in symptomatic and asymptomatic patients","volume":"75","author":"Deery","year":"2022","unstructured":"Deery SEHolscher CMNejim B, et al. In-hospital and one-year outcomes are similar for women and men following transcarotid artery revascularization in symptomatic and asymptomatic patients. J Vasc Surg. 2022;75(2):572-580.e3."},{"issue":"8","key":"bib15","series-title":"J Neurointerv Surg","first-page":"842","article-title":"Transcarotid artery revascularization (TCAR): a technical video","volume":"14","author":"Sujijantarat","year":"2022","unstructured":"Sujijantarat NAntonios JKoo A, et al. Transcarotid artery revascularization (TCAR): a technical video. J Neurointerv Surg. 2022;14(8):842."},{"issue":"1","key":"bib16","series-title":"Sci Rep","first-page":"3507","article-title":"Precise MEP monitoring with a reduced interval is safe and useful for detecting permissive duration for temporary clipping","volume":"10","author":"Kameda","year":"2020","unstructured":"Kameda MHishikawa THiramatsu MYasuhara TKurozumi KDate I. Precise MEP monitoring with a reduced interval is safe and useful for detecting permissive duration for temporary clipping. Sci Rep. 2020;10(1):3507."},{"issue":"2","key":"bib17","series-title":"Asian J Neurosurg","first-page":"237","article-title":"Optimal use of temporary clip application during aneurysm surgery\u2014in search of the Holy Grail","volume":"16","author":"Kumar","year":"2021","unstructured":"Kumar SSahana DMenon G. Optimal use of temporary clip application during aneurysm surgery\u2014in search of the Holy Grail. Asian J Neurosurg. 2021;16(2):237-242."},{"issue":"6","key":"bib18","series-title":"J Neurosurg","first-page":"817","article-title":"Temporary occlusion of the middle cerebral artery in intracranial aneurysm surgery: time limitation and advantage of brain protection","volume":"87","author":"Lavine","year":"1997","unstructured":"Lavine SDMasri LSLevy MLGiannotta SL. Temporary occlusion of the middle cerebral artery in intracranial aneurysm surgery: time limitation and advantage of brain protection. J Neurosurg. 1997;87(6):817-824."},{"issue":"5","key":"bib19","series-title":"J Neurosurg","first-page":"785","article-title":"Temporary vessel occlusion for aneurysm surgery: risk factors for stroke in patients protected by induced hypothermia and hypertension and intravenous mannitol administration","volume":"84","author":"Ogilvy","year":"1996","unstructured":"Ogilvy CSCarter BSKaplan SRich CCrowell RM. Temporary vessel occlusion for aneurysm surgery: risk factors for stroke in patients protected by induced hypothermia and hypertension and intravenous mannitol administration. J Neurosurg. 1996;84(5):785-791."},{"key":"bib20","series-title":"Surg Neurol Int","first-page":"79","article-title":"Safe time duration for temporary middle cerebral artery occlusion in aneurysm surgery based on motor-evoked potential monitoring","volume":"8","author":"Tanabe","year":"2017","unstructured":"Tanabe JIshikawa TMoroi J. Safe time duration for temporary middle cerebral artery occlusion in aneurysm surgery based on motor-evoked potential monitoring. Surg Neurol Int. 2017;8:79."},{"issue":"2","key":"bib21","series-title":"J Vasc Surg","first-page":"584","article-title":"Duration of blood flow reversal during transcarotid artery revascularization does not affect outcome","volume":"72","author":"Kumins","year":"2020","unstructured":"Kumins NHKing AHJim J, et al. Duration of blood flow reversal during transcarotid artery revascularization does not affect outcome. J Vasc Surg. 2020;72(2):584-588."},{"issue":"2","key":"bib22","series-title":"J Endovasc Ther","first-page":"265","article-title":"Transcarotid artery revascularization with flow reversal","volume":"24","author":"Alpaslan","year":"2017","unstructured":"Alpaslan AWintermark MPint\u00e9r LMacdonald SRuedy RKolvenbach R. Transcarotid artery revascularization with flow reversal. J Endovasc Ther. 2017;24(2):265-270."},{"key":"bib23","series-title":"Ann Vasc Surg","first-page":"11","article-title":"Impact of flow reversal duration on neurological outcomes of transcarotid artery revascularization (TCAR)","volume":"89","author":"Naazie","year":"2023","unstructured":"Naazie INDodo-Williams TJanssen CLane JSmeds MRMalas M. Impact of flow reversal duration on neurological outcomes of transcarotid artery revascularization (TCAR). Ann Vasc Surg. 2023;89:11-19."},{"key":"bib24","series-title":"Clin Neurosurg","first-page":"248","article-title":"Microsurgical anatomy of common aneurysm sites","volume":"26","author":"Rhoton","year":"1979","unstructured":"Rhoton ALJrSaeki NPerlmutter DZeal A. Microsurgical anatomy of common aneurysm sites. Clin Neurosurg. 1979;26:248-306."},{"key":"bib25","series-title":"Rhoton Cranial Anatomy and Surgical Approaches","author":"Rhoton","year":"2020","unstructured":"Rhoton AL. Rhoton Cranial Anatomy and Surgical Approaches. Oxford University Press; 2020."},{"key":"bib26","article-title":"501(k) Summary for enroute transcarotid neuroprotection system","unstructured":"Administration. 501(k) Summary for enroute transcarotid neuroprotection system. Accessed October 11, 2023. https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf23\/K230402.pdf"},{"issue":"5","key":"bib27","series-title":"Interv Neuroradiol","first-page":"580","article-title":"Intra-aneurysmal microcatheter looping technique for stent-assisted embolization of complex intracranial aneurysms","volume":"21","author":"Wang","year":"2015","unstructured":"Wang CCLv NFeng ZZ, et al. Intra-aneurysmal microcatheter looping technique for stent-assisted embolization of complex intracranial aneurysms. Interv Neuroradiol. 2015;21(5):580-584."},{"issue":"1","key":"bib28","series-title":"Oper Neurosurg (Hagerstown)","first-page":"E39","article-title":"Distal access to wide-necked aneurysms\u2014\u2018around the world\u2019 technique: 2-dimensional operative video","volume":"20","author":"Ringer","year":"2020","unstructured":"Ringer AJ, Endovascular Neurosurgery Research Group (ENRG). Distal access to wide-necked aneurysms\u2014\u2018around the world\u2019 technique: 2-dimensional operative video. Oper Neurosurg (Hagerstown). 2020;20(1):E39-E40."},{"key":"bib29","series-title":"J Neurointerv Surg","author":"Sujijantarat","year":"2024","unstructured":"Sujijantarat NRenedo DAntonios J, et al. Use of a dedicated open transcarotid access system for neurovascular disease. J Neurointerv Surg. 2024. 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