Table of Contents

Anterior communicating artery aneurysm surgery

Approaches

Anterior communicating artery aneurysm surgery approaches.

Patients with very small ruptured anterior communicating artery aneurysms can be safely and effectively treated with endovascular coiling. However, smaller ACoA aneurysms still require surgical clipping. A smaller aneurysm size limits the use of endovascular coiling 1).

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 2) 3) 4) 5).

Complications

see Anterior communicating artery aneurysm surgery complications

References

1)
Zhao B, Xing H, Fan L, Tan X, Zhong M, Pan Y, Wan J. Endovascular coiling versus surgical clipping of very small ruptured anterior communicating artery aneurysms. World Neurosurg. 2019 Mar 18. pii: S1878-8750(19)30735-1. doi: 10.1016/j.wneu.2019.03.074. [Epub ahead of print] PubMed PMID: 30898747.
2)
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.
3)
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.
4)
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.
5)
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.