A1-A2 interposition grafting for surgical treatment of a giant "unclippable" A1 segment aneurysm.
BACKGROUND
Although various bypass options for the surgical treatment of middle cerebral artery aneurysms have been described, little has been reported about similar options for complex aneurysms of the anterior cerebral artery.


METHODS
We report the case of a 15-year-old adolescent girl, in whom a giant A1 segment aneurysm was successfully treated with aneurysm resection followed by saphenous vein interposition grafting.


CONCLUSIONS
Recognizing the option for a bypass can be the key to success in the surgical management of complex intracranial aneurysms. A potential donor vessel of appropriate size (either arterial or venous) should be prospectively identified. Interposition grafting is technically feasible for proximal anterior cerebral artery aneurysms, although technically demanding.
Hauck
Erik Friedrich
EF
Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. erik.hauck@utsouthwestern.edu
Samson
Duke
D
D000293:Adolescent; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006261:Headache / Q000209:etiology; D006423:Hemianopsia / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019586:Intracranial Hypertension / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008599:Menstruation Disturbances / Q000209:etiology; D009325:Nausea / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D012501:Saphenous Vein / Q000033:anatomy & histology / Q000637:transplantation*; D013525:Surgical Instruments; D016378:Tissue Transplantation / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D017287:Ventriculoperitoneal Shunt