Distal anterior cerebral artery (DACA) aneurysms represent 2–9 % of intracranial aneurysms. They are often more amenable to surgical rather than endovascular treatment due to the size of parent vessels.
We illustrate surgical approaches for DACA aneurysms arising from different segments of the anterior cerebral artery. Cases range from simple unruptured aneurysms to complex ruptured aneurysms requiring reconstruction and intracranial bypass.
The interhemispheric approach typically provides an adequate surgical corridor for surgical clipping of DACA aneurysms. Patient positioning, image guidance, and preoperative angiography help maximize safety and efficacy of surgery.
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Distal anterior cerebral artery
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The authors thank Cindy H. Samos and Greta Beekhuis for assistance with the manuscript.
Disclosure of Funding
This study was supported in part by the Edward G. Hills Fund, Russell and Elizabeth Siegelman, Bernard and Ronni Lacroute, and the William Randolph Hearst Foundation (to GKS).
The authors have no personal financial or institutional interest in any of the drugs, materials or devices described in this article.
Conflicts of interest
Medtronic Neuroscience Strategic Advisory Board (GKS).
Ramon Navarro, MD – Conception and design, collection and assembly of data, data analysis, interpretation, manuscript writing and editing and video, final manuscript review
Kevin Chao, MD – Conception and design, collection and assembly of data, data analysis, interpretation, manuscript writing and editing, final manuscript review
Gary K. Steinberg, MD, PhD – Conception and design, data analysis, interpretation, manuscript writing and editing, final manuscript review
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Navarro, R., Chao, K. & Steinberg, G.K. Microsurgical management of distal anterior cerebral artery aneurysms: from basic to complex, a video review of four cases. Acta Neurochir 155, 2115–2119 (2013) doi:10.1007/s00701-013-1855-1
- Distal anterior cerebral artery
- Intracranial aneurysms
- Microsurgical clipping