Giant Serpentine Internal Carotid Artery Aneurysm with Complex Aortic and Supra-aortic Vascular Anatomy: Endovascular Treatment through Direct Percutaneous Carotid Puncture

Giant serpentine aneurysm (GSA) with rare aortic and supra-aortic vascular anomaly is technically difficult to treat. Often such patients suffer without treatment. We have treated a patient by a different approach which is not regularly followed. This case has many developmental anomalies with complicated anatomy, and it is a challenge to the treating interventionist.