Proximal occlusion of the dominant anterior cerebral artery for anterior communicating aneurysm.

Twenty-seven patients with ruptured and one with symptomatic unruptured anterior communicating aneurysms were treated by proximal clip occlusion of the dominant anterior cerebral artery. These patients have been followed for 2 to 4 1/2 years and the results evaluated. The operation carried a very low mortality rate (3.5%) and a relatively low morbidity. There was no instance of recurrent hemorrhage during the study period. Clinical and preoperative angiographic criteria for selection of patients and the timing and technique of surgery are discussed.