title: Giant intracranial aneurysm of the anterior communicating artery treated by direct surgery using A3-A3 side-to-side anastomosis and A3-RA graft-STA anastomosis.
abstract: We describe a giant aneurysm of the anterior communicating artery (ACoA) which was treated with a STA-RA graft-A3 bonnet bypass and A3-A3 side-to-side anastomosis. A giant and partially thrombosed ACoA aneurysm was partially coated 3 years before his current presentation, its gradual increase producing visual field disturbances. An A3-A3 side-to-side anastomosis and STA-RA graft-A3 bonnet bypass were performed. The aneurysm was dissected, and the thrombus removed under transient parent-artery occlusion. The aneurysmal neck was successfully clipped without encountering ischemic changes. This strategy may be useful for treating giant or thrombosed aneurysms in the region of the ACoA.
authors.affiliation: Department of Neurosurgery, Neurosurgical Institute, Chiba Hokuso Hospital, Nippon Medical School, Japan. kyongson@nms.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Kim
authors.forename: T
authors.initials: T
authors.lastname: Mizunari
authors.forename: N
authors.initials: N
authors.lastname: Mizutani
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: K
authors.initials: K
authors.lastname: Takizawa
authors.forename: H
authors.initials: H
authors.lastname: Kamiyama
authors.forename: Y
authors.initials: Y
authors.lastname: Murai
authors.forename: A
authors.initials: A
authors.lastname: Teramoto
mesh_terms: D000328:Adult; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D009897:Optic Chiasm / Q000098:blood supply / Q000473:pathology; D017534:Radial Artery / Q000601:surgery; D013525:Surgical Instruments / Q000592:standards; D013699:Temporal Arteries / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome