AI Article Synopsis
- Anterior communicating artery (ACOM) aneurysms are common in cases of subarachnoid hemorrhage and can be difficult to treat, particularly those projecting posterior-superiorly due to anatomical challenges.
- Surgical clipping of these aneurysms requires special techniques because nearby vessels can obstruct the view and interfere with the procedure.
- The study includes a detailed description of the surgical anatomy and presents a video demonstrating a successful surgical technique using a lateral supraorbital craniotomy and fenestrated tandem clipping.
Article Abstract
Background: Anterior communicating artery (ACOM) aneurysms are among the most common aneurysms associated with aneurysmal subarachnoid hemorrhage (International Study of Unruptured Intracranial Aneurysms I (N Engl J Med 339:1725-1733, 1998), Wiebers (Lancet 362:103-110, 2003)). Surgical clipping of posterior-superiorly projecting ACOM aneurysms can be challenging, as the ipsilateral A2 can interfere with clip trajectory and ACOM perforating vessels obstructed from view. Intraluminal coils can further increase the difficulty of the procedure.
Method: The relevant surgical anatomy with illustration is presented. A video detailing our technique on an illustrative case is provided.
Conclusion: Surgical clipping of posterior-superiorly projecting ACOM aneurysms can require complex clip configurations. We describe the key steps of posterior-superiorly projecting ACOM aneurysm clipping through a lateral supraorbital craniotomy and fenestrated tandem clipping.
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| http://dx.doi.org/10.1007/s00701-024-06279-5 | DOI Listing |
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Article Synopsis
- Anterior communicating artery (ACOM) aneurysms are common in cases of subarachnoid hemorrhage and can be difficult to treat, particularly those projecting posterior-superiorly due to anatomical challenges.
- Surgical clipping of these aneurysms requires special techniques because nearby vessels can obstruct the view and interfere with the procedure.
- The study includes a detailed description of the surgical anatomy and presents a video demonstrating a successful surgical technique using a lateral supraorbital craniotomy and fenestrated tandem clipping.
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