Advertisement

Microsurgical management of distal anterior cerebral artery aneurysms: from basic to complex, a video review of four cases

  • 386 Accesses

  • 3 Citations

Abstract

Background

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.

Method

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.

Conclusion

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.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 199

This is the net price. Taxes to be calculated in checkout.

Fig. 1
Fig. 2

Abbreviations

AVMs:

Arteriovenous malformations

DACA:

Distal anterior cerebral artery

ICG:

Indocyanine green

References

  1. 1.

    Hui FK, Schuette AJ, Moskowitz SI, Spiotta AM, Lieber ML, Rasmussen PA, Dion JE, Barrow DL, Cawley CM (2011) Microsurgical and endovascular management of pericallosal aneurysms. J Neurointerv Surg 3:319–323

  2. 2.

    Laakso A (2010) Surgical management of cerebrovascular disease. Springer Wien, New York

  3. 3.

    Lehecka M, Lehto H, Niemela M, Juvela S, Dashti R, Koivisto T, Ronkainen A, Rinne J, Jaaskelainen JE, Hernesniemi JA (2008) Distal anterior cerebral artery aneurysms: treatment and outcome analysis of 501 patients. Neurosurgery 62:590–601, discussion 590–601

  4. 4.

    Lehecka M, Porras M, Dashti R, Niemela M, Hernesniemi JA (2008) Anatomic features of distal anterior cerebral artery aneurysms: a detailed angiographic analysis of 101 patients. Neurosurgery 63:219–228, discussion 228–219

  5. 5.

    Yasargil M (1984) Distal anterior cerebral artery aneurysms. Georg Thieme Verlag, Stuttgart

  6. 6.

    Lawton M (2011) Seven Aneurysms. Tenets and techniques for clipping. Thieme Medical Publishers, Inc

Download references

Acknowledgements

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).

Disclosure

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).

Author information

Correspondence to Gary K. Steinberg.

Additional information

Author Contributions

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

Electronic supplementary material

Below is the link to the electronic supplementary material.

(MP4 102188 kb)

ESM 1

(MP4 102188 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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

Download citation

Keywords

  • Distal anterior cerebral artery
  • Intracranial aneurysms
  • Microsurgical clipping
  • Pericallosal