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 via an institution to check access.
Similar content being viewed by others
Abbreviations
- AVMs:
-
Arteriovenous malformations
- DACA:
-
Distal anterior cerebral artery
- ICG:
-
Indocyanine green
References
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
Laakso A (2010) Surgical management of cerebrovascular disease. Springer Wien, New York
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
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
Yasargil M (1984) Distal anterior cerebral artery aneurysms. Georg Thieme Verlag, Stuttgart
Lawton M (2011) Seven Aneurysms. Tenets and techniques for clipping. Thieme Medical Publishers, Inc
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
Authors and Affiliations
Corresponding author
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)
Rights 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). https://doi.org/10.1007/s00701-013-1855-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-013-1855-1