A com A – A2 aneurysm
You will be watching surgery for an anterior communicating artery (ACOM A) and A2 aneurysms. Because these types of aneurysms sit on a broad base, coiling is not possible. The dome of this aneurysm was attached to the brain. After dissecting and separating the adhesions, I used a 90-degree angled clip to create an L-shaped base.
In the diagrams below, I have drawn the normal A Com A -A1- A2 relationship, the appearance of only the upward-facing type of A Com A aneurysm, and representative shapes of a complex A Com A aneurysm arising from Acom and the opposite A2.
CT angiography showing the appearance of an A-Com-A aneurysm. Frontal view.
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Appearance of the aneurysm after right pterional craniotomy and synovial dissection.
A Com A and A2 are marked with a dashed line.
The location of the aneurysm, its boundaries, and an artery passing over the aneurysm have been marked.
At the end of the surgery, both A Com A and Sol A2 are seen restored with an L-shaped clip.