Revascularization of the anterior cerebral artery with an A3-A3 anastomosis and a superficial temporal artery bypass using an A3-radial artery graft to trap a giant anterior communicating artery aneurysm: technical case report.
OBJECTIVE
How to manage the distal anterior cerebral artery (ACA) circulation in the treatment of a giant anterior communicating artery aneurysm or a giant azygous A2 aneurysm is still controversial.


METHODS
We are reporting the case of a 70-year-old man who presented with an evolving giant thrombosed anterior communicating artery aneurysm.


METHODS
He was successfully treated by trapping the aneurysm in conjunction with an A3-A3 side-to-side anastomosis and a superficial temporal artery bypass using an A3-radial artery graft. The postoperative angiography showed an excellent filling of all the bilateral distal ACA area through the bypass.


CONCLUSIONS
In cases in which direct clipping to preserve distal ACA flow is quite difficult, the bilateral ACA revascularization described here should be considered as another possibility.
Department of Neurosurgery, Showa General Hospital, Tokyo, Japan.
Tomohiro
T
Inoue
Kazuo
K
Tsutsumi
Hiroyasu
H
Ohno
Munehisa
M
Shinozaki
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D002548:Cerebral Revascularization / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000637:transplantation*; D011859:Radiography; D013699:Temporal Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome