Effect of clipping anterior communicating artery aneurysms via pterional approach contralateral to supply of dominant blood: report of 15 patients.

BACKGROUND AND PURPOSE Anterior communicating artery aneurysm (ACoAA) is a common cerebrovascular disease. This research is to observe the curative effect and safety of clipping anterior communicating artery (ACoA) aneurysms by microsurgery through the pterional approach contralateral to supply of dominant blood. MATERIALS AND METHODS Before the surgery, three-dimensional-DSA (3D-DSA) was performed to study the regional anatomy of ACoA complexes in all 15 patients with ACoA aneurysms. According to 3D-DSA, the aneurysms and ACoA complexes could be satisfactorily exposed by the microsurgery through the pterional approach contralateral to the supply of dominant blood. And then the microsurgery through the pterional approach contralateral to the supply of dominant blood was performed in 15 patients with ACoA aneurysms. RESULTS Clipping of ACoA aneurysms were successfully performed in all patients. The aneurysms and ACoA complexes were satisfactorily exposed via 3D-DSA. Among 15 patients with ACoA aneurysms, 14 cases were cured and 1 case need further care. CONCLUSIONS The ideal side of pterional approach may be cheese via simulation of pterional approach with 3D-DSA. The ACoA complex and aneurysm can be clearly exposed, and the aneurysm may be smoothly clipped safely by the microsurgery through the ideal side pterional approach contralateral to supply of dominant blood in the patients with ACoA aneurysms.