Supraclinoid internal carotid artery fenestration harboring an unruptured aneurysm and another remote ruptured aneurysm: case report and review of the literature.

A fenestration of the supraclinoid internal carotid artery (ICA) is a rare congenital condition. We report an aneurysm arising from the proximal end of an ICA fenestration that was treated by endovascular coiling. Three-dimensional rotational angiography of preoperative cerebral angiography provided an understanding of the complex anatomy of the aneurysms associated with the fenestration and may facilitate the clinical decision regarding the treatment option. Endovascular coiling appears to be safe and effective for treating an aneurysm originating from a fenestration on the supraclinoid ICA, which is a difficult lesion to treat using a conventional surgical approach.