A combined technique for treating certain aneurysms of the anterior communicating artery

Abstract

✓ Thirty-one patients with aneurysms of the anterior communicating artery that filled from both sides during carotid arteriography were treated by a combined operative procedure consisting of clip-ligation of one proximal anterior cerebral artery followed by gradual occlusion of the opposite common carotid artery with a Crutchfield clamp. In 14 patients, intravascular pressure recordings in the carotid vessels in the neck were obtained both before and immediately after ligation of the anterior cerebral artery. Before ligation the average intravascular pressure reduction was 55%, while after ligation the average reduction was 71%. Of the 31 patients, 22 have had good results and no recurrent hemorrhage. Nine patients died, four from recurrent hemorrhage. Follow-up carotid arteriography in nine patients showed the aneurysm obliterated in six, smaller in one, and unchanged in two. The results of this study indicate that treatment of certain anterior communicating aneurysms by the combined operative approach described is useful.