A combined technique for treating certain aneurysms of the anterior communicating artery

1970 ◽  
Vol 33 (1) ◽  
pp. 41-47 ◽  
Author(s):  
George T. Tindall ◽  
John Kapp ◽  
Guy L. Odom ◽  
Stephen C. Robinson
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Operative Procedure ◽  
Anterior Communicating Artery ◽  
Recurrent Hemorrhage ◽  
Content Type ◽  
Proximal Anterior Cerebral Artery ◽  
Carotid Vessels ◽  
Intravascular Pressure

✓ Thirty-one patients with aneurysms of the anterior communicating artery that filled from both sides during carotid arteriography were treated by a combined operative procedure consisting of clip-ligation of one proximal anterior cerebral artery followed by gradual occlusion of the opposite common carotid artery with a Crutchfield clamp. In 14 patients, intravascular pressure recordings in the carotid vessels in the neck were obtained both before and immediately after ligation of the anterior cerebral artery. Before ligation the average intravascular pressure reduction was 55%, while after ligation the average reduction was 71%. Of the 31 patients, 22 have had good results and no recurrent hemorrhage. Nine patients died, four from recurrent hemorrhage. Follow-up carotid arteriography in nine patients showed the aneurysm obliterated in six, smaller in one, and unchanged in two. The results of this study indicate that treatment of certain anterior communicating aneurysms by the combined operative approach described is useful.

The results of proximal anterior cerebral artery occlusion for anterior communicating aneurysms

1972 ◽  
Vol 37 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Herman Hugenholtz ◽  
Thomas P. Morley
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Late Results ◽  
Artery Occlusion ◽  
Recurrent Hemorrhage ◽  
Content Type ◽  
Proximal Anterior Cerebral Artery ◽  
Cerebral Artery Occlusion ◽  
Fine Print

✓ A 3- to 10-year follow-up of a selected group of 23 patients treated for ruptured anterior communicating aneurysms by proximal clipping of one anterior cerebral artery has been evaluated. There was no instance of recurrent hemorrhage. The operation carried a relatively low morbidity and mortality (13%). Early and late results are compared. The importance of adequate preoperative angiography, the minimal complications, and the advantages of the procedure are discussed.

Ligation of an anterior cerebral artery for aneurysms of the anterior communicating artery complex

1973 ◽  
Vol 38 (4) ◽  
pp. 481-487 ◽  
Author(s):  
Michael Scott
Keyword(s):  
Clinical Data ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Long Term Follow Up ◽  
Fine Print

✓ The clinical data on nine patients with aneurysms of the anterior communicating artery complex treated by ligation of an anterior cerebral artery are presented. The long-term follow-up angiograms on five of the eight patients who survived surgery are discussed.

Proximal occlusion of the anterior cerebral artery for anterior communicating aneurysm

1975 ◽  
Vol 43 (4) ◽  
pp. 426-431 ◽  
Author(s):  
Anthony D. Hockley
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Artery Occlusion ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Mortality And Morbidity ◽  
Proximal Anterior Cerebral Artery ◽  
Technical Simplicity ◽  
Proximal Occlusion ◽  
Cerebral Artery Occlusion

✓ Results of proximal anterior cerebral artery occlusion are described in 68 patients with anterior communicating artery aneurysms. The procedure is found useful in the treatment of these aneurysms because of its technical simplicity and the low rates of mortality and morbidity achieved.

Occlusion of an “accessory” distal anterior cerebral artery during treatment of anterior communicating artery aneurysms

1991 ◽  
Vol 74 (1) ◽  
pp. 133-135 ◽  
Author(s):  
Kevin Gibbons ◽  
Leo N. Hopkins ◽  
Roberto C. Heros
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Anterior Communicating Artery ◽  
Case Histories ◽  
Content Type ◽  
Anterior Communicating Artery Aneurysms ◽  
Artery Segment ◽  
Distal Anterior Cerebral Artery ◽  
Clip Occlusion ◽  
Fine Print

✓ Two cases are presented in which clip occlusion of a third distal anterior cerebral artery segment occurred during treatment of anterior communicating artery aneurysms. Case histories, angiograms, operative descriptions, and postmortem findings are presented. The incidence of this anomalous vessel is reviewed. Preoperative and intraoperative vigilance in determining the presence of this anomaly prior to clip placement is emphasized.

Aneurysmal subarachnoid hemorrhage in a patient with bilateral A1 fenestrations associated with an azygos anterior cerebral artery

1996 ◽  
Vol 84 (4) ◽  
pp. 681-684 ◽  
Author(s):  
Robert M. Friedlander ◽  
Christopher S. Ogilvy
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Vascular Anatomy ◽  
Vascular Anomaly ◽  
Rare Occurrence ◽  
Content Type ◽  
Proximal Anterior Cerebral Artery ◽  
Current Article

✓ Fenestration of the proximal anterior cerebral artery (A1 segment) is a rare occurrence. This vascular anomaly is often associated with aneurysms and other abnormalities. The current article describes the case of a 33-year-old man who presented with a subarachnoid hemorrhage secondary to a ruptured aneurysm originating from the proximal end of an A1 fenestration. This patient also had a contralateral A1 fenestration as well as an azygos anterior cerebral artery. This is the first report of such an unusual vascular anatomy. The literature is reviewed and possible embryological mechanisms are discussed.

Microsurgical anatomy of the distal anterior cerebral artery

1978 ◽  
Vol 49 (2) ◽  
pp. 204-228 ◽  
Author(s):  
David Perlmutter ◽  
Albert L. Rhoton
Keyword(s):  
Corpus Callosum ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Internal Capsule ◽  
Optic Chiasm ◽  
Anterior Communicating Artery ◽  
Microsurgical Anatomy ◽  
Content Type ◽  
Cm Points ◽  
Distal Anterior Cerebral Artery

✓ The microsurgical anatomy of the distal anterior cerebral artery (ACA) has been defined in 50 cerebral hemispheres. The distal ACA, the portion beginning at the anterior communicating artery (ACoA), was divided into four segments (A2 through A5) according to Fischer. The distal ACA gave origin to central and cerebral branches. The central branches passed to the optic chiasm, suprachiasmatic area, and anterior forebrain below the corpus callosum. The cerebral branches were divided into cortical, subcortical, and callosal branches. The most frequent site of origin of the cortical branches was as follows: orbitofrontal and frontopolar arteries, A2; the anterior and middle internal frontal and callosomarginal arteries, A3; the paracentral artery, A4; and the superior and inferior parietal arteries, A5. The posterior internal frontal artery arose with approximately equal frequency from A3 and A4 and the callosomarginal artery. All the cortical branches arose more frequently from the pericallosal than the callosomarginal artery. Of the major cortical branches, the internal frontal and paracentral arteries arose most frequently from the callosomarginal artery. The distal ACA of one hemisphere sent branches to the contralateral hemisphere in 64% of brains. The anterior portions of the hemisphere between the 5-cm and 15-cm points on the circumferential line showed the most promise of revealing a recipient artery of sufficient size for an extracranial-intracranial artery anastomosis. The distal ACA was the principal artery supplying the corpus callosum. The recurrent artery, which arose from the A2 segment in 78% of hemispheres, sent branches into the subcortical area around the anterior limb of the internal capsule.

Carotid-anterior cerebral artery anastomosis

1976 ◽  
Vol 44 (3) ◽  
pp. 378-382 ◽  
Author(s):  
Stephen Nutik ◽  
Domenico Dilenge
Keyword(s):  
Optic Nerve ◽  
Cerebral Artery ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
Anterior Cerebral Artery ◽  
Optic Chiasm ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Anatomical Features ◽  
Fine Print

✓ The angiographic and anatomical features of an anomalous communication between the intradural internal carotid artery and the anterior cerebral artery are described. Essential features of the anastomosis include an origin at, or close to, the origin of the ophthalmic artery, a course ventral to the ipsilateral optic nerve and anterior to the optic chiasm, and a termination near the anterior communicating artery. Although rare, the condition should be considered as an entity. The incidence of associated berry aneurysm and other congenital vascular anomalies is high.

Aneurysms arising from the proximal (A1) segment of the anterior cerebral artery

1992 ◽  
Vol 76 (3) ◽  
pp. 455-458 ◽  
Author(s):  
Michiyasu Suzuki ◽  
Takehide Onuma ◽  
Yoshiharu Sakurai ◽  
Kazuo Mizoi ◽  
Akira Ogawa ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Radical Surgery ◽  
Septum Pellucidum ◽  
Anterior Communicating Artery ◽  
Fusiform Aneurysm ◽  
Content Type ◽  
Perforating Artery ◽  
Anterior Communicating Artery Aneurysms ◽  
High Incidence

✓ This study reviews aneurysms of the proximal segment (A1) of the anterior cerebral artery in 38 patients (23 men and 15 women) and their surgical, angiographic, and clinical management. Thirty-seven aneurysms were saccular and one was fusiform. The incidence of A1 aneurysms among a total of 4295 aneurysm cases treated was 0.88%. Multiple aneurysms occurred in 17 patients (44.7%) of the 38 cases; in 10 (58.8%), there was bleeding from the A1 aneurysm. The aneurysms were classified into five categories according to the mode of origin of the aneurysm in relation to the A1 segment: in 21 cases, aneurysms originated from the junction of the A1 segment and a perforating artery; in eight, from the A1 segment directly; in six, from the proximal end of the A1 fenestration; and in two, from the junction of the A1 segment and the cortical branch. One patient had a fusiform aneurysm. Computerized tomography (CT) of these aneurysms revealed bleeding extending to the septum pellucidum similar to that of anterior communicating artery aneurysms. When performing radical surgery it is very important to recognize the characteristics of A1 aneurysms, including multiplicity, a high incidence of vascular anomalies (especially A1 fenestration), and their similarity to anterior communicating artery aneurysms on CT.

Reinforcement with gauze wrapping for ruptured aneurysms of the middle cerebral artery

1977 ◽  
Vol 47 (6) ◽  
pp. 828-832 ◽  
Author(s):  
Julien C. Taylor ◽  
Abdur R. Choudhury
Keyword(s):  
Mortality Rate ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Recurrent Hemorrhage ◽  
Content Type ◽  
Mortality And Morbidity ◽  
Ruptured Aneurysms ◽  
Follow Up Study ◽  
Fine Print

✓ A 2- to 15-year follow-up study is presented of a series of 35 consecutive patients treated for ruptured aneurysms of the middle cerebral artery by reinforcement with gauze wrapping. Only one patient suffered early recurrent hemorrhage in the postoperative period, and none had a late hemorrhage. The procedure carried a relatively low mortality rate (8.6%). Morbidity was the direct sequel of preoperative conditions. Wrapping is an effective and safe treatment of these aneurysms, with a low mortality and morbidity, and freedom from occlusive infarcts.

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