Reconstruction of posterior cerebral artery (PCA) could be performed with superficial temporal artery-PCA (STA-PCA) bypass, in situ PCA-superior cerebellar artery (PCA-SCA) bypass, or P2-P2 reanastomosis. The PCA and SCA are anatomically parallel; however, the PCA caliber is typically double that of the SCA, which limits the utility of PCA-SCA bypass. When treating some complex P2 aneurysms, end-to-end P2-P2 reanastomosis could be performed directly. However, due to the small redundancy and tortuosity of the PCA, it is difficult to perform end-to-end reanastomosis after resection of a giant aneurysm.