Entrar/Registro  
HOME SPANISH
 
Cirugía y Cirujanos
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Cirugía y Cirujanos >Year 2013, Issue 4


Monroy-Sosa A, Pérez-Cruz JC, Reyes-Soto G, Delgado-Hernández C, Macías-Duvignau MA, Delgado-Reyes L
Microsurgical anatomy importance of A1- anterior communicating artery complex
Cir Cir 2013; 81 (4)

Language: Español
References: 45
Page: 274-281
PDF: 391.87 Kb.

[Full text - PDF]

ABSTRACT

Background: The anterior cerebral artery originates from the bifurcation of the internal carotid artery lateral to the optic chiasm, then joins with its contralateral counterpart via the anterior communicating artery. A1- anterior communicating artery complex is the most frequent anatomical variants and is the major site of aneurysms between 30 to 37%.
Objective: Know the anatomy microsurgical, variants anatomical and importance of complex precommunicating segment-artery anterior communicating in surgery neurological of the pathology vascular, mainly aneurysms, in Mexican population.
Methods: The study was performed in 30 brains injected. Microanatomy was studied (length and diameter) of A1- anterior communicating artery complex and its variants.
Results: 60 segments A1, the average length of left side was 11.35 mm and 11.84 mm was right. The average diameter of left was 1.67 mm and the right was 1.64 mm. The average number of perforators on the left side was 7.9 and the right side was 7.5. Anterior communicating artery was found in 29 brains of the optic chiasm, its course depended on the length of the A1 segment. The average length of the segment was 2.84 mm, the average diameter was 1.41 mm and the average number of perforators was 3.27. A1- anterior communicating artery complex variants were found in 18 (60%) and the presence of two blister-like aneurysms.
Conclusion: It is necessary to understand the A1- anterior communicating artery complex microanatomy of its variants to have a three-dimensional vision during aneurysm surgery.


Key words: anterior cerebral artery, anterior communicating artery, anatomical variants, blister-like aneurysm.


REFERENCES

  1. Rhoton AL Jr. The Supratentorial arteries. Neursurgery 2002;51(4 suppl):S53-120.

  2. Gibo H, Lenkey C, Rhoton AL. Microsurgical anatomy of the supraclinoid portion of the internal carotid artery. J Neurosurg 1981;55:560-574.

  3. Baptista AG. Studies on the arteries of the brain II. The anterior cerebral artery: some anatomic features and their clinical implications. Neurology 1963;13:825-835.

  4. Stehbens, W. Aneurysm and anatomical variations of cerebral arteries. Arch Pathol 1963;15:5-64.

  5. Marinković S, Milisavljević M, Marinković Z. Branches of anterior communicating artery. Microsurgical anatomy Acta Neurochir 1990;106:78-85.

  6. Wong ST, Yuen SC, Fok KF, Yam KY, Fong D. Infraoptic anterior cerebral artery: review, report of two cases and an anatomical classification. Acta Neurochir 2008;150:1087-1096.

  7. Quinteros-Olivares ST, Ballesteros-Acuña LE, Ayala-Pimentel JO, Forero-Porras PL. Características morfológicas de aneurismas cerebrales del polígono de Willis: estudio anatómico directo. Neurocirugía 2009;20:110-116.

  8. Uchino A, Nomiyama K, Takase Y, Kudo S. Anterior cerebral artery variations detected by MR angiography. Neuroradiology 2006;48:647-652.

  9. Suzuki J, Ohara H. Origin and growth of cerebral aneurysms. A Clinicopathological study. En Pia, H. W. C. Langmaid, J. Ziers-ki editores. Cerebral Aneursyms, Advances in Diagnosis and Therapy. Berlin:Springer; Berlin,1979;28-41.

  10. Yasargil MG. Microanatomy, vol. II. New York: Thieme-Stratton, 1984;72-108.

  11. Riina HA, Lemole GM Jr, Spetzler RF. Anterior communicating artery aneurysms. Neurosurgery 2002;51:993-996.

  12. Sekhar LN, Natarajan SK, Britz GW, Ghodke B. Microsurgical Management of Anterior Communicating Artery Aneurysm. Neurosurgery 2007;61:273-292.

  13. Hernesniemi J, Dashti R, Lehecka M, Niemelä M, Rinne J, Lehto H, et al. Microneurosurgical management of anterior communicating artery aneurysms. Surg Neurol 2008;70:8-29.

  14. Wanibuchi M, Kurokawa Y, Ishiguro M, Fujishige M, Inaba K. Characteristics of aneurysms arising from the horizontal portion of the anterior cerebral artery. Surg Neurol 2001;55:148-154.

  15. Instituto Nacional de Estadística y Geografía, INEGI. Defunciones generales totales por principales causas de mortalidad, 2008. [Actualizado en 2010, abr 14; consultado en 2011, jun 10]. Disponible en http://www.inegi.org.mx/sistemas/sisept/Default. aspx?t=mdemo107&s=est&c=23587. ok, verificada

  16. Kassell NF, Torner JC, Haley EC Jr, Jane JA, Adams HP, Kongable GL. The International Cooperative Study on the Timing of Aneurysm Surgery: Part 1-Overall management results. J Neurosurg 1990;73:18-36.

  17. Yasargil MG. Microanatomy, vol. I. New York: Thieme- Stratton,1984;92-128.

  18. Karazincir S, Ada E, Sarsilmaz A, Sarilmaz A, Yalçin O, Vidinli B, et al. Frequency of vascular variations and anomalies accompanying intracranial aneurysms. Tani Girisim Radyol 2004; 10: 103-109.

  19. Tao X, Yu XJ, Bhattarai B, Li TH, Jin H, Wei GW, et al. Microsurgical anatomy of the anterior communicating artery complex in adult Chinese heads. Surgical Neurology 2006;65:155-161.

  20. Suazo de la Cruz LE, Garbugino SL, Moreno GA, Lemme-Plaghos L. Evaluación anatomoangiográfica del complejo de la arteria comunicante anterior en casos de aneurismas de dicho sector. Rev Argent Neuroc 2002;16:1-8.

  21. Martínez F, Spagnuolo E, Calvo Rubal A, Laza S, Sgarbi N, Soria VR, et al. Variaciones del sector anterior del polígono de Willis. Correlación anatomo-angiográfica y su implicancia en la cirugía de aneurismas intracraneanos. Neurocirugía 2004;15:578-589.

  22. Kobayashi S, Yuge T, Sugita Y, Kuratomi A, Katayama M, Iryo O, et al. Azygos anterior cerebral artery aneurysm associated with fenestration of the anterior cerebral artery. Kurume Med J 1986;33:149-153.

  23. Aktüre E, Arat A, Niemann DB, Salamat Salamat M, Baskaya MK. Bilateral A1 fenestrations: Report of two cases and literature review. Surg Neurol Int 2012;3:244-246.

  24. Koh JS, Kim EJ, Lee SH, Bang JS. Ruptured Aneurysm Arising from the Distal End of a Proximal A1 Fenestration: Case Report and Review of the Literature. J Korean Neurosurg Soc 2009;45:43- 45.

  25. Ito J, Washiyama K, Kim CH, Ibuchi Y. Fenestration of the Anterior Cerebral Artery. Neuroradiology 1981;21:277-280.

  26. Perlmutter D, Rhoton AL Jr. Microsurgical anatomy of the anterior cerebral-anterior communicating-recurrent artery complex. J Neurosurg 1976;45:259-272.

  27. Gomes F, Dujovny M, Umansky F, Ausman JI, Diaz FG, Ray WJ, et al. Microsurgical anatomy of the recurrent artery of Heubner. J Neurosurg 1984;60:130-139.

  28. Padget, DH. The development of the embryonic intersegmental arteries in reference to the vertebral artery and subclavian stem. Anat Rec 1954;119:349-356.

  29. Fujimoto Y, Yamanaka K, Nakajima Y, Yoshimura K, Yoshimine T. Ruptured Aneurysm Arising From the Proximal End of an Azygos Anterior Cerebral Artery. Case Report. Neurol Med Chir 2004;44:242-244.

  30. Huber P, Braun J, Hirschmann D, Agyeman JF. Incidence of Berry Aneurysms of the Unpaired Pericallosal Artery: Angiographic Study. Neuroradiology 1980;19:143-147.

  31. Hayashi M, Kobayashi H, Kawano H, Handa Y, Kabuto M. Giant aneurysm of an azygos anterior cerebral artery: report of two cases and review of the literature. Neurosurgery 1985;17:341- 344.

  32. Huh JS, Park SK, Shin JJ, Kim TH. Saccular Aneurysm of the Azygos Anterior Cerebral Artery: Three Case Reports. J Korean Neurosurg Soc 2007;42:342-345.

  33. Auguste KI, Ware ML, Lawton MT. Nonsaccular aneurysms of the azygos anterior cerebral artery. Neurosurg Focus 2004;17:1-5.

  34. Namiki J, Doumoto Y. Microsurgically Critical Anomaly of the Anterior Communicating Artery Complex During the Pterional Approach to a Ruptured Aneurysm: Double Fenestration of the Proximal A2 Segments. Neurol Med Chir 2003;43:304-307.

  35. Kwak R, Niizuma H, Hatanaka M, Suzuki J. Anterior communicating artery aneurysms with associated anomalies. J Neurosurg 1980;52:162-164.

  36. Avci E, Fossett D, Aslan M, Attar A, Egemen N. Branches of the Anterior Cerebral Artery Near the Anterior Communicating Artery Complex: an Anatomic Study and Surgical Perspective. Neurol Med Chir 2003;43:329-333.

  37. Dunker RO, Harris AB. Surgical anatomy of the proximal anterior cerebral artery. J Neurosurg 1976;44:359-367.

  38. Sasaki T, Kodama N, Matsumoto M, Suzuki K, Konno Y, Sakuma J, et al. Blood flow disturbance in perforating arteries attributable to aneurysm surgery. J Neurosurg 2007;107:60-67.

  39. Nathal E, Yasui N, Sampei T, Suzuki A. Intraoperative anatomical studies in patients with aneurysms of the anterior communicating artery complex. J Neurosurg 1992;76:629-634.

  40. Vincentelli F, Lehman G, Caruso G, Grisoli F, Rabehanta P, Gouaze A. Extracerebral course of the perforating branches of the anterior communicating artery: Microsurgical anatomic study. Surg Neurol 1991;35:98-104.

  41. Ogawa A, Suzuki M, Ogasawara K. Aneurysms at Nonbranching Sites in the Supraclinoid Portion of the Internal Carotid Artery: Internal Carotid Artery Trunk Aneurysms. Neurosurgery 2000;47:578-586.

  42. Sim SY, Shin YS, Cho KG, Kim SY, Kim SH, Ahn YH, et al. Blood blister-like aneurysms at nonbranching sites of the internal carotid artery. J Neurosurg 2006;105:400-405.

  43. Andaluz N, Zuccarello M. Blíster–Like Aneurysm of the Anterior Communicating Artery: A Retrospective Review of Diagnosis and Treatment in Five Patients. Neurosurgery 2008;62:807-811.

  44. Morris TC, Brophy BP. Blister like aneurysm of the anterior communicating artery. J Clin Neurosci. 2009;16:1098-1100.

  45. Aydin, IH, Takçi E, Kadioglu HH, Tüzün Y, Kayaoglu ÇR, Barlas E. Vascular Variations Associated with Anterior Communicating Artery Aneurysms - An Intraoperative Study. Minim. Invasive neurosurg 1997;40:17-21.






>Journals >Cirugía y Cirujanos >Year 2013, Issue 4
 

· Journal Index 
· Links 
       
Copyright 2010