OBJECTIVE: To report our surgical experience using in situ end-to-side bypass for giant serpentine distal anterior cerebral artery aneurysm, unsuitable for microsurgical clipping. METHODS: A 49-year-old woman presented with headache and intermittent loss of consciousness. The brain computed tomography scan revealed a partially calcified mass in the interhemispheric fissure. On cerebral angiography, that was giant (30×18 mm sized), serpentine aneurysm originating from the A2 to A3 segment of the distal anterior cerebral artery (DACA). The aneurysm was trapped with clips, and the right A3 segment to left A3 segment of DACA, end-to-side in situ bypass was performed. Surgical result was favorable, with no newly developed ischemic event in the acute recovery period. Postoperative angiography showed total occlusion of the aneurysm and good patency, with preserved distal flow. CONCLUSION: Giant fusiform aneurysms of the DACA are extremely rare and can be particularly challenging to treat. End-to-side A3 : A3 bypass with aneurysm trapping could be a treatment modality for these locations.
OBJECTIVE: To report our surgical experience using in situ end-to-side bypass for giant serpentine distal anterior cerebral artery aneurysm, unsuitable for microsurgical clipping. METHODS: A 49-year-old woman presented with headache and intermittent loss of consciousness. The brain computed tomography scan revealed a partially calcified mass in the interhemispheric fissure. On cerebral angiography, that was giant (30×18 mm sized), serpentine aneurysm originating from the A2 to A3 segment of the distal anterior cerebral artery (DACA). The aneurysm was trapped with clips, and the right A3 segment to left A3 segment of DACA, end-to-side in situ bypass was performed. Surgical result was favorable, with no newly developed ischemic event in the acute recovery period. Postoperative angiography showed total occlusion of the aneurysm and good patency, with preserved distal flow. CONCLUSION: Giant fusiform aneurysms of the DACA are extremely rare and can be particularly challenging to treat. End-to-side A3 : A3 bypass with aneurysm trapping could be a treatment modality for these locations.
Authors: Martin Lehecka; Hanna Lehto; Mika Niemelä; Seppo Juvela; Reza Dashti; Timo Koivisto; Antti Ronkainen; Jaakko Rinne; Juha E Jääskeläinen; Juha A Hernesniemi Journal: Neurosurgery Date: 2008-03 Impact factor: 4.654
Authors: Martin Lehecka; Reza Dashti; Juha Hernesniemi; Mika Niemelä; Timo Koivisto; Antti Ronkainen; Jaakko Rinne; Juha Jääskeläinen Journal: Surg Neurol Date: 2008-05-16