Intraoperative evaluation of cerebral hemodynamics using directional Doppler technique

1979 ◽  
Vol 50 (5) ◽  
pp. 570-577 ◽  
Author(s):  
Helge Nornes ◽  
Arne Grip ◽  
Per Wikeby
Keyword(s):  
Flow Velocity ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Parent Artery ◽  
Collateral Flow ◽  
Probe Position ◽  
Content Type ◽  
Doppler Technique ◽  
Proximal Anterior Cerebral Artery ◽  
Artery Flow

✓ The use of a pulsed echo Doppler technique during procedures for occlusion of intracranial aneurysms is described. Saccular aneurysms can be located with reference to probe position and depth setting. Tracings of intra-aneurysmal flow are presented, and the characteristic flow pattern is discussed. Special emphasis has been placed on the parent artery flow, particularly the effect of lumen reduction on flow velocity. Results of flow velocity studies on the cognate (direct) and collateral flow in the middle cerebral artery and the proximal anterior cerebral artery are presented and discussed.

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.

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.

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.

scholarly journals Hemodynamic Effect of Unequal Anterior Cerebral Artery Flow Rates on the Anterior Communicating Artery Bifurcation: A Computational Fluid Dynamics Study

2008 ◽  
Vol 2008 ◽  
pp. 1-9 ◽  
Author(s):  
Thomas Rau ◽  
Xing He ◽  
Prem Venugopal ◽  
Fernando Viñuela ◽  
Gary Duckwiler ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Hemodynamic Effect ◽  
Anterior Communicating Artery ◽  
Parent Artery ◽  
Symmetric Model ◽  
Flow Rates ◽  
Artery Flow

Computational fluid dynamics techniques were used to investigate the hemodynamic effect of unequal anterior cerebral artery flow rates on the anterior cerebral and anterior communicating artery (ACA-ACOM) bifurcation. Hemodynamics have long been implicated as a major factor in cerebrovascular disease. Using an idealized 2D symmetric model of the ACA-ACOM geometry, the flow field and wall shear stress (WSS) at the bifurcation regions are assessed for pulsatile inflows with left to right flow ratios of 1:1, 2:1, 3:1, and 4:1. Unequal flow rates through the ACA parent arteries result in bifurcation of the higher flow parent stream and a shifting of the impingement points along the A2-ACOM adjoining wall toward the contralateral ACA. Cross-flow through the ACOM is generally unstable and results in increased WSS at the impingement region from the higher flow parent artery and a double amplitude peak in the WSS at the contralateral bifurcation region from local recirculation effects. These results suggest that asymmetry in ACA flow rates result in increased hemodynamic stresses at the ACA-ACOM bifurcation regions and suggest a possible factor for vessel weakening and aneurysm formation.

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.

Surgical treatment of distal anterior cerebral artery aneurysms

1979 ◽  
Vol 50 (1) ◽  
pp. 40-44 ◽  
Author(s):  
Takashi Yoshimoto ◽  
Keita Uchida ◽  
Jiro Suzuki
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Parent Artery ◽  
Content Type ◽  
Aneurysm Neck ◽  
Horizontal Portion ◽  
Distal Anterior Cerebral Artery ◽  
Fine Print

✓ Between June, 1961, and September, 1975, the authors operated on 60 patients with aneurysms of the anterior cerebral artery distal to the anterior communicating artery (ACoA) by a direct intracranial approach. It is of utmost importance in the treatment of aneurysms to have control of the parent artery of the aneurysm. This makes it easier and safer to approach the aneurysm neck and to handle possible premature aneurysm rupture. The aneurysms were classified into two types, ascending and horizontal. Aneurysms arising from the origin of the ACoA and including the entire portion of the knee of the corpus callosum were designated as aneurysms of the ascending portion, whereas aneurysms beyond the genu were designated as aneurysms of the horizontal portion. For aneurysms of the ascending portion, bifrontal craniotomy was considered the safest approach. For aneurysms of the horizontal portion, a small parasagittal craniotomy was determined to be sufficient.

scholarly journals Dissecting Aneurysm at the Proximal Anterior Cerebral Artery Treated by Parent Artery Occlusion

2009 ◽  
Vol 15 (1) ◽  
pp. 123-126 ◽  
Author(s):  
M. Lv ◽  
X. Lv ◽  
Y. Li ◽  
C. Jiang ◽  
P. Jiang ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Artery Occlusion ◽  
Dissecting Aneurysm ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Proximal Anterior Cerebral Artery ◽  
Neuroform Stent

Aneurysms of the A1 segment of the anterior cerebral artery (ACA) are rare. We described the first documented endovascular treatment of an A1 portion dissecting aneurysm by parent artery occlusion. A 43-year-old man patient presented with subarachnoid hemorrhage. Cerebral angiography demonstrated a dissecting aneurysm of the left anterior cerebral artery (ACA) at A1 portion. Because of the dissecting nature of the A1 portion aneurysm, a 2.5×15-mm Neuroform stent was placed in the left A1 portion. However, regrowth of the aneurysm was found on the three month follow-up angiogram, so the aneurysm and the left A1 portion of ACA were occluded completely.

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