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| Name | Trapping of the Anterior Communicating Artery in a Case of Blister or Very Small Aneurysm |
| Video Uploader | Video From NEUROLOGY INDIA VIDEOS |
| Upload Date | This Video Uploaded At 11-06-2023 04:17:13 |
| Video Discription | Blister aneurysms are inherently dehiscent aneurysms in which neck clipping can lead to tearing of the same and to catastrophic consequences. Additionally, very small aneurysms are exceedingly difficult to clip due to a non-discernible anatomical neck, with attempts at clipping leading to either parent artery occlusion or stenosis. Microsurgical options include bypass, parent vessel occlusion, or wrapping or trapping of the aneurysm. Endovascular studies of very small aneurysms have shown a higher rupture and complication rate with a combined rate of periprocedural mortality and morbidity of 7.3%. We thus propose trapping of such aneurysms especially in areas where collateral supply is present, like the anterior communicating artery (ACoA). This type of aneurysm surgery is possible in type 1 and 2 Sengupta classification and needs to be tailored to specific cases in which it leads to good outcomes. The technique is not without risks. The most probable ones being occlusion of perforators arising from the anterior communicating artery supplying the optic chiasm and hypothalamus. The applicability in Type 1 and typ 2 circulations only is understood. Thus, this technique is only chosen in cases of ruptured Anterior communicating artery aneurysms, as collateral supply from other perforators has already taken over minimizing the risk for further deficits. Previous cases have reported some cognitive dysfunction due to perforator spasm but the same was not seen in our case. |
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