Technical Consideration in Clipping of the Anterior Communicating Aneurysms: The Gyrus Rectus Approach, Report of Two Operative Cases

Kang, Joon Ki; Song, Jin Un

Abstract

The anterior communicating artery(Acomm) is one of more common sites of intracranial aneurysms. Surgery of anterior communicating aneurysm has been considered difficult because it is deep, and proximity to the vital diencephalic centers and it projects in various directions and its parent artery is thin or thourgh the sac, sometimes having vascular anomalies. Successful treatment of aneurysms by intracranial surgery requires careful planning of the surgical approach. The gyrus rectus approach to anterior communicating aneurysms is based on the belief that since aneurysms rupture at their fundus they can most safely be approached at their base because premature rupture of an aneurysm is deleterious to appropriate surgical treatment. From January to October 1982, 20 cases with ruptured aneurysms of the Acomm have been operated on using microsurgical procedures. We have presented 2 patients of Acomm aneurysms with certain difficult in clipping neck. The double aneurysms were obliterated with two clips and the other aneurysm was clipped with the long length clip and also the inclusion of adjacent vital nerves and vessels in the clips were avoided. Technical problems associated with the application of the clips are discussed.