Clinical Outcome of Pterional Approach to the Anterior Communicating Artery Aneurysm Surgery According to Identification of H-Complex.
- Author:
Jong Gun KIM
1
;
Hyung Dong KIM
Author Information
1. Department of Neurosurgery, College of Medicine Dong-A University, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Anterior communicating artery;
Aneurysm H-complex;
Pterional approach;
junction;
Postoperative outcome
- MeSH:
Aneurysm;
Intracranial Aneurysm*
- From:Journal of Korean Neurosurgical Society
2002;31(6):551-557
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: In case of the anterior communicating artery(A-com A) aneurysm surgery with pterional approach, complete identification of A-com A complex(H-complex) has been thought to be important and influence the clinical results. The authors present a retrospetive analysis to determine the significance of identification of H-complex in A-com A surgery. METHODS: We analysed 90 cases among 116 cases that were operated the A-com A aneurysm with pterional approach from June 1993 to May 1998. The cases were classified according to aneurysmal direction, size, and placement of A1-A2 junction by preoperative angiogram and intraoperative findings. RESULTS: Incomplete visualization of H-complex was influenced by the approach side to the anteriorly placed A1-A2 junction, larger than 11mm in aneurysmal size and superior or posterior direction of aneurysm. Postoperative outcome was influenced by Hunt-Hess grade, and seemed to be better when the approach was performed to side of the posteriorly placed A1-A2 junction with or without dominant A1, but aneurysmal direction was not concerned with postoperative outcome. CONCLUSION: The results suggest that in A-com A aneurysm surgery with pterional approach, careful evaluation of preoperative angiogram and approach to the side of the posteriorly placed A1-A2 junction lead to better outcome.
