Intraoperative anatomical studies in patients with aneurysms of the anterior communicating artery complex

Edgar Nathal Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan

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 M.D.
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Nobuyuki Yasui Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan

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 M.D.
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Takeshi Sampei Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan

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 M.D.
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Akifumi Suzuki Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan

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 M.D.
Page Range:
629–634
Volume/Issue:
Volume 76: Issue 4
DOI link:
https://doi.org/10.3171/jns.1992.76.4.0629
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✓ The intraoperative anatomical findings of the anterior communicating artery (ACoA) complex in 46 patients with anatomical variations were compared to those in an equal number of patients without variations in order to determine the visualization of the elements of the vascular complex. All patients underwent radical surgery for an ACoA aneurysm by one of three different surgical approaches: transsylvian, anterior interhemispheric, or basal interhemispheric. Visualization of the vascular elements was similar in patients with or without anatomical variations. The differences observed were dependent on the surgical approach selected and on the projection of the aneurysm. It was found that, even when the intraoperative anatomical field and the number of vascular elements visualized are different from those obtained in autopsy studies, the vascular microanatomical characteristics can be confirmed with each surgical approach to the extent necessary to ensure safe clipping of aneurysms in patients both with and without anatomical variations.

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Contributor Notes

Address for Dr. Nathal: Division of Surgical Neurology, National Institute of Neurology and Neurosurgery-Mexico, Av. Insurgentes Sur 3877, CP. 14269, Mexico City, Mexico.
Address reprint requests to: Noboyuki Yasui, M.D., Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-Akita, 6,10 Senshu-kubota-machi, Akita 010, Japan.
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