Microsurgery for anterior communicating artery aneurysms (report of 115 cases)

WANG Lu; LI Jun; CHEN Wen; XU Hao; HE Miao; XING Biao

doi:10.13798/j.issn.1009-153X.2017.05.005

Abstract：Objective To study the clinical effect of microsurgery on anterior communicating artery aneurysms.Methods The clinical data of 115 patients with anterior communicating artery aneurysms treated in Wuhan Municipal Central Hospital from January,2009 to January,2016 were analyzed retrospectively.3D-CTA and (or) 3D-DSA was performed before the operation in all the patients,in whom the aneurysms were clipped by neurosurgery via pterional approach.3D-simulated operations were performed in all the patients.The preoperative diagnosis,microsurgical aneurysm exposure technique,the prevention of the intraoperative complications and curative effects were analyzed.Results Of 115 patients with anterior communicating artery aneurysms,27 belonged in Hunt-Hess grade Ⅰ,45 in the grade Ⅱ,31 in the grade Ⅲll,9 in the grade Ⅳ and 3 in the grade V before the surgery.Postoperative follow-up period was from 3 months to 3 years.Of these 115 patients,89 were recovered well,18 moderately disabled,4 severely disabled and 4 died according to GOS grading system.Conclusions The 3D-simulated.operation is helpful to the preoperative understanding of aneurysm morphology and perforating vessels.The postoperative complications can be decreased and life quality can be enhanced by the microneurosurgery via the pterional approach in the patients with anterior communicating artery aneurysms.