INTRAOPERATIVE ANATOMICAL STUDIES IN PATIENTS WITH ANEURYSMS OF THE ANTERIOR COMMUNICATING ARTERY COMPLEX

The intraoperative anatomical findings of the anterior communicating a rtery (ACoA) complex in 46 patients with anatomical variations were co mpared to those in an equal number of patients without variations in o rder to determine the visualization of the elements of the vascular co mplex. All patients underwent radical surgery for an ACoA aneurysm by one of three different surgical approaches: transsylvian, anterior int erhemispheric, or basal interhemispheric. Visualization of the vascula r elements was similar in patients with or without anatomical variatio ns. The differences observed were dependent on the surgical approach s elected and on the projection of the aneurysm. It was found that, even when the intraoperative anatomical field and the number of vascular e lements visualized are different from those obtained in autopsy studie s, the vascular microanatomical characteristics can be confirmed with each surgical approach to the extent necessary to ensure safe clipping of aneurysms in patients both with and without anatomical variations.