Novel use of the pipeline embolization device for reperfusion of the middle cerebral artery post surgical aneurysm clipping.

We describe a case in which elective surgical clipping of an internal carotid artery terminus aneurysm resulted in compromised flow through the ipsilateral middle cerebral artery (MCA). Reperfusion was salvaged the following day with novel use of the pipeline embolization device to buttress open the MCA. We believe that mechanical properties unique to the pipeline device facilitated the success of the procedure.