Microsurgical Treatment of Anterior Communicating Artery Aneurysms: An Analysis of 74 Consecutive Cases. Approach Side Choice and Outcome Considerations

Abstract: Introduction Anterior communicating artery aneurysms (ACoAAs) are intracranial aneurysms whose treatment is still considered a challenging task. Materials and Methods Altogether, 74 patients were included in this study. The variables included age, sex, comorbidities, incidence of subarachnoid hemorrhage (SAH), the Fisher, Hunt-Hess, and WFNS scores, approach side, length of hospital stay, and mortality. We also investigate A1/A2 dimensions, association with approach side choice and the influence of surgeon's experience on the outcome. Results There were 61 patients (82.2%) admitted with SAH and 13 were treated for unruptured aneurysms. The A1 and A2 branches were larger ipsilaterally to the selected approach side (p < 0,001). No deaths occurred in the unruptured aneurysm group. In the SAH group, mortality was strongly correlated with the Hunt-Hess score (p < 0.001), Fisher grade (p < 0.001), and WFNS score (p < 0.001). No significant difference was found in mortality between the right-side and the left-side approaches (p = 0.253). A significant survival difference was identified on the group operated by the senior surgeon versus the non-senior group (p = 0.048). Discussion and Conclusion A1 dominance was identified as a factor associated to the approach side for SAH cases at our center. Understanding the factors involved in brain aneurysm surgery remains a relevant and underexplored subject. Further studies involving larger case series and multicenter collaborations are necessary to elucidate these factors and to determine the external validity of our findings.

Object Details

• Alternative title: Tratamento microcirúrgico de aneurismas da artéria comunicante anterior: Uma análise de 74 casos consecutivos. Escolha da abordagem e considerações sobre resultados
• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Microsurgical Treatment of Anterior Communicating Artery Aneurysms: An Analysis of 74 Consecutive Cases. Approach Side Choice and Outcome Considerations ; volume:42 ; number:04 ; year:2023 ; pages:e302-e308 ; Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery ; 42, Heft 04 (2023), e302-e308

Contributors, Places and Time

• Contributor: Pinheiro, Leon Cleres Penido ; Junior, Mario Wolak ; Salgado, Joao Lucas ; Neto, Francisco L. de A. Moura ; Filho, Pedro Tadao Hamamoto ; Zanini, Marco Antonio ; Fernandes, Adriano Yacubian

Further information

• DOI: 10.1055/s-0043-1776269
• URN: urn:nbn:de:101:1-2024010411545080584551
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:36 AM CEST