Results of microsurgical treatment of distal anterior cerebral artery aneurysms
Keywords:
craniotomy, intracranial aneurysm, microsurgery, subarachnoid hemorrhageAbstract
Introduction: Distal aneurysms of the anterior cerebral artery are rare vascular lesions. Microsurgical clipping constitutes a therapeutic modality used in a traditional way, which is accompanied by high complexity due to its intricate and varied topography, as well as its close neurovascular relationships.
Objective: To describe the surgical results of distal aneurysms of the anterior cerebral artery operated by microsurgical clipping.
Methods: A descriptive, prospective study was carried out, which included 11 distal aneurysmal sacs of the anterior cerebral artery operated by microsurgical clamping at the Hermanos Ameijeiras Hospital. An interhemispheric and pterional approach was performed. Imaging, preoperative and postoperative clinical variables were used with greater importance related to the Glasgow Coma Scale for results and complications. For data analysis, absolute and relative frequencies were used as summary measures.
Results: Aneurysms with A3 or Precallosal topography predominated (45.5%); and of size between 6-10 millimeters (66.6%). The interhemispheric approach was used most frequently (72.7%); and clipping was achieved in all patients. There was a predominance of the Glasgow Coma Scale for results of 4 (36.4%) and 5 (54.5%). Among the main complications, pneumonia and hydrocephalus (18.2%), respectively, stood out.
Conclusions: Microsurgical clipping in patients with distal aneurysms of the anterior cerebral artery is characterized by being a safe, effective procedure with low complications related to the surgical procedure.
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