Revascularization of the Anterior Cerebral Artery with an A3–A3 Anastomosis and a Superficial Temporal Artery Bypass Using an A3-Radial Artery Graft to Trap a Giant Anterior Communicating Artery Aneurysm: Technical Case Report

Abstract

Abstract OBJECTIVE AND IMPORTANCE: How to manage the distal anterior cerebral artery (ACA) circulation in the treatment of a giant anterior communicating artery aneurysm or a giant azygous A2 aneurysm is still controversial. CLINICAL PRESENTATION: We are reporting the case of a 70-year-old man who presented with an evolving giant thrombosed anterior communicating artery aneurysm. INTERVENTION: He was successfully treated by trapping the aneurysm in conjunction with an A3–A3 side-to-side anastomosis and a superficial temporal artery bypass using an A3-radial artery graft. The postoperative angiography showed an excellent filling of all the bilateral distal ACA area through the bypass. CONCLUSION: In cases in which direct clipping to preserve distal ACA flow is quite difficult, the bilateral ACA revascularization described here should be considered as another possibility.