Cerebral revascularization for anterior cerebral artery applied in surgery of the complex anterior communicating artery aneurysms

Abstract

The bypass surgery for anterior communicating artery (ACoA) aneurysms is a considerable option for the radical treatment of complex ACoA aneurysms and maintaining the perfusion of anterior cerebral artery (ACA) territories. The bypass modalities with the aim to rebuild the function of ACoA are complicated and technically challenging. For vascular architecture, the ACoA as the anterior pivot of the circle of Willis is remotely situated to traditional donor vessels, while bilateral efferent arteries should be treated as recipient vessels, and the anatomical variability of ACoA complex further complicate these situations. For surgical application, the working corridor is deep and narrow, so bypass procedure necessitates deep anastomosis. Thus the traditional surgical exposure requires two separate approaches to access the proximal afferent and distal efferent arteries for vascular control and anastomosis. In this article, we review the available innovative modifications that designed in order to create individualized strategies for each patient because of the complexity of hemodynamics and the vascular architecture.

doi：10.3969/j.issn.1672⁃6731.2021.07.001