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- Tomohiro Inoue, Kazuo Tsutsumi, Hiroyasu Ohno, and Munehisa Shinozaki.
- Department of Neurosurgery, Showa General Hospital, Tokyo, Japan.
- Neurosurgery. 2005 Jul 1; 57 (1 Suppl): E207; discussion E207.
Objective And ImportanceHow to manage the distal anterior cerebral artery (ACA) circulation in the treatment of a giant anterior communicating artery aneurysm or a giant azygous A2 aneurysm is still controversial.Clinical PresentationWe are reporting the case of a 70-year-old man who presented with an evolving giant thrombosed anterior communicating artery aneurysm.InterventionHe was successfully treated by trapping the aneurysm in conjunction with an A3-A3 side-to-side anastomosis and a superficial temporal artery bypass using an A3-radial artery graft. The postoperative angiography showed an excellent filling of all the bilateral distal ACA area through the bypass.ConclusionIn cases in which direct clipping to preserve distal ACA flow is quite difficult, the bilateral ACA revascularization described here should be considered as another possibility.
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