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.
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.
Kim
K
K
Department of Neurosurgery, Neurosurgical Institute, Chiba Hokuso Hospital, Nippon Medical School, Japan. kyongson@nms.ac.jp
Mizunari
T
T
Mizutani
N
N
Kobayashi
S
S
Takizawa
K
K
Kamiyama
H
H
Murai
Y
Y
Teramoto
A
A
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