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anterior_communicating_artery_aneurysm_surgery

Anterior communicating artery aneurysm surgery

The surgical approach may be difficult because of the complex arterial relationship, perforator preservation, frequent association between aneurysms and AcoA anomaly, and the potential for cognitive dysfunction. Especially, the high positioned ACoA aneurysms or posterior superior directed AcoA aneurysms have an additional complicating features. They need more brain retraction or their neck is usually associated intimately with the hypothalamic or infundibular perforators and frequently, one or both A2 segments densely adherent to the body of the aneurysm 1) 2) 3) 4).

There are two main types of approaches for anterior communicating artery aneurysms, namely pterional approach and an interhemispheric approach 5) 6).

A pterional approach is the most common for aneurysm surgery, not only for anterior circulation aneurysms but also for basilar tip aneurysms. There are some variations for the interhemispheric approach including bifrontal, unifrontal, basal interhemispheric, and transcrista galli interfalcine approaches.


see Pterional approach for anterior communicating artery aneurysm

see Interhemispheric approach for anterior communicating artery aneurysm

1)
Cognard C, Weil A, Spelle L, Piotin M, Castsings L, Rey A, et al. Long-term angiographic follow-up of 169 intracranial berry aneurysms occluded with detachable coils. Radiology. 1999;212:348–356.
2)
Fertl E, Killer M, Eder H, Linzmayer L, Richling B, Auff E. Long-term functional effects of aneurysmal subarachnoid haemorrhage with special emphasis on the patient's view. Acta Neurochir (Wien) 1999;141:571–577.
3)
Moret J, Pierot L, Boulin A, Castaings L, Rey A. Endovascular treatment of anterior communicating artery aneurysms using Guglielmi detachable coils. Neuroradiology. 1996;38:800–805.
4)
Proust F, Debono B, Hannequin D, Gerardin E, Clavier E, Langlois O, et al. Treatment of anterior communicating artery aneurysms : complementary aspects of microsurgical and endovascular procedures. J Neurosurg. 2003;99:3–14.
5)
Li JW, Shi CH. Endovascular treatment of complicated ruptured anterior communicating artery aneurysms based on the anatomical features of the anterior communicating artery complex. Neurology India. 2012;60:55–60.
6)
Matsukawa H, Uemura A, Fujii M, Kamo M, Takahashi O, Sumiyoshi S. Morphological and clinical risk factors for the rupture of anterior communicating artery aneurysms. J Neurosurg. 2013;118:978–983.
anterior_communicating_artery_aneurysm_surgery.txt · Last modified: 2016/09/18 17:56 (external edit)