Hosseini Ehsan Mohammad, Aghamiri Seyed Hossein, Haridas Abilash, Natarajan Sabareesh, Peyvandi Maryam, Sourani Arman
Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ann Med Surg (Lond). 2024 Oct 16;86(12):7351-7355. doi: 10.1097/MS9.0000000000002646. eCollection 2024 Dec.
There are few cases of multiple simultaneous anterior communicating artery (AComA) aneurysms with A2 triplication and AComA duplication.
(1) A fenestrated AComA with a saccular aneurysm (neck diameter 9 mm; dome height 8 mm) projecting superiorly from the distal AComA branch, as well as an anomalous artery arising from the posterior surface of the same AComA. (2) A duplicate AComA with a saccular aneurysm (neck diameter of 5 mm; dome height of 9 mm) projecting superioposteriorly from the distal AComA branch, as well as an anomalous artery arising from the anterior surface of the same AComA was diagnosed. Both were treated by microsurgical titanium clip occlusion.
Anatomical variations are believed to enhance the risk of anterior communicating artery (AComA) aneurysms, accounting for ~30% of all intracranial aneurysms. In such circumstances, the goal is to occlude the aneurysmal lesions safely while preserving the patency of other branches.
AComA aneurysms accompanied by anomalous triplicated A2 and fenestrated AComA are rare and challenging. Such complex cases response best using microsurgery using titanium clip occlusion with durable favorable outcomes.
同时存在前交通动脉（AComA）多发动脉瘤且伴有A2段重复和AComA重复的病例很少见。
（1）一个开窗型AComA，远端AComA分支上有一个向上突出的囊状动脉瘤（颈部直径9毫米；瘤顶高度8毫米），以及同一AComA后表面发出的一条异常动脉。（2）诊断出一个重复的AComA，远端AComA分支上有一个向后上方突出的囊状动脉瘤（颈部直径5毫米；瘤顶高度9毫米），以及同一AComA前表面发出的一条异常动脉。两者均通过显微手术钛夹夹闭治疗。
解剖变异被认为会增加前交通动脉（AComA）动脉瘤的风险，约占所有颅内动脉瘤的30%。在这种情况下，目标是在保留其他分支通畅的同时安全地闭塞动脉瘤病变。
伴有异常重复A2段和开窗型AComA的AComA动脉瘤罕见且具有挑战性。此类复杂病例采用显微手术钛夹夹闭效果最佳，可获得持久良好的结果。
