Microsurgical clipping of true posterior communicating artery aneurysms

Acta Neurochir (Wien). 2012 Sep;154(9):1707-10. doi: 10.1007/s00701-012-1435-9. Epub 2012 Jul 26.

Abstract

Background: "True" posterior communicating artery (PCOM) aneurysms are rare variants in which the aneurysm arises solely from the PCOM rather than the junction of the internal carotid artery and the PCOM.

Methods: It is critical to note that for true PCOM aneurysms, the neck arises distal to the origin of the PCOM and therefore lies in what is traditionally an intra-operative blind spot. The PCOM must be followed posteriorly to visualise the aneurysm neck for microsurgical clipping.

Conclusions: A thorough pre-operative understanding of this unique anatomy is essential in minimising morbidity associated with microsurgical clipping of this aneurysm configuration.

MeSH terms

  • Cerebral Angiography
  • Craniotomy / methods
  • Dissection / methods
  • Humans
  • Image Interpretation, Computer-Assisted
  • Imaging, Three-Dimensional
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / surgery*
  • Intraoperative Complications / prevention & control
  • Microsurgery / methods*
  • Prognosis
  • Surgical Instruments*
  • Tomography, X-Ray Computed
  • Ultrasonography, Doppler, Transcranial
  • Ultrasonography, Interventional