scholarly journals Partial Resection of the Gyrus Rectus in Pterional Approach to Anterior Communicating Artery Aneurysms

1992 ◽  
Vol 32 (3) ◽  
pp. 136-139 ◽  
Author(s):  
Tohru HORIKOSHI ◽  
Hideaki NUKUI ◽  
Shigeru MITSUKA ◽  
Masami KANEKO
Keyword(s):  
Partial Resection ◽  
Anterior Communicating Artery ◽  
Pterional Approach ◽  
Anterior Communicating Artery Aneurysms ◽  
Gyrus Rectus

Transorbital Keyhole Approach to Anterior Communicating Artery Aneurysms

Neurosurgery ◽  
2001 ◽  
Vol 48 (2) ◽  
pp. 347-352 ◽  
Author(s):  
Hans- J. Steiger ◽  
Robert Schmid-Elsaesser ◽  
Walter Stummer ◽  
Eberhard Uhl
Keyword(s):  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysms ◽  
Invasive Method ◽  
Tailored Approach ◽  
Interhemispheric Fissure ◽  
Safe Control ◽  
Keyhole Approach ◽  
Gyrus Rectus ◽  
Better Than

Abstract OBJECTIVE The transorbital keyhole approach to anterior communicating artery aneurysms was developed as a minimally invasive method for safe control of the anterior communicating artery complex. This approach does not necessitate resection of the gyrus rectus. METHODS The technique is described in detail. The transorbital keyhole approach provides more ventral access than the supraorbital approaches, and the anterior communicating artery complex can be controlled by splitting the basal aspect of the interhemispheric fissure. RESULTS Since late 1998, the authors have used the transorbital keyhole approach routinely. During the initial experience with 33 patients, the only observed complication specific to this approach was transient diplopia in one patient. At follow-up examinations 2 to 15 months after surgery, the cosmetic results were favorable as compared with those of standard pterional craniotomy. CONCLUSION We have designed a small, custom-tailored approach to the anterior communicating artery complex for routine use. The small orbitocranial approach is a step toward the ideal of purely extra-axial safe control of anterior communicating artery aneurysms. The orbitocranial keyhole approach seems to be substantially better than the craniotomy, although it requires additional effort and time.

Partial Gyrus Rectus Resection as a Technique to Improve the Exposure to the Anterior Communicating Artery Complex through the Junctional Triangle: A Quantitative Study

2020 ◽  
Author(s):  
Daniel Valli ◽  
Xiaochun Zhao ◽  
Evgenii Belykh ◽  
Qing Sun ◽  
Michael T. Lawton ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Outcome Measures ◽  
Quantitative Study ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Anterior Communicating Artery ◽  
Pterional Approach ◽  
Before And After ◽  
The Mean ◽  
Gyrus Rectus

Abstract Objective The junctional triangle, formed by the distal A1 anterior cerebral artery (ACA) segment, the proximal A2 ACA segment, and the medial surface of gyrus rectus (GR), is a corridor of access to superiorly and posteriorly projecting anterior communicating artery (AComA) aneurysms that is widened by GR retraction or resection. Exposure of the AComA complex through the junctional triangle after GR resection has not been previously quantitatively evaluated. Design GR resection extent and increase in artery exposure through the junctional triangle were assessed in this study. Setting This study was conducted in the laboratory with a pterional approach, exposing the AComA complex. Participants Ten sides of five cadaveric heads were considered. Main Outcome Measures Exposure extent of ipsilateral and contralateral A1, A2, and AComA and accessibility of branches coming off the AComA complex were measured before and after GR resection. The GR was resected until sufficient bilateral A2 and contralateral A1 exposures were achieved. GR resection span was measured. Results The mean (standard deviation) resected span of GR was 7 ± 3.9 mm. After GR resection, the exposed span of the ipsilateral A2 increased from 2 ± 0.7 mm to 4 ± 1.1 mm (p = 0.001); contralateral A2 exposure increased from 3 ± 1.5 mm to 4 ± 1.1 mm (p = 0.03). Contralateral recurrent artery of Heubner (RAH) and orbitofrontal artery were accessible in five and eight specimens, respectively, before GR resection and in all 10 after resection. Conclusion GR resection improves exposure of bilateral A2 segments through the junctional triangle. Exposure improvement is greater for the ipsilateral A2 than contralateral A2. The junctional triangle concept is enhanced by partial GR resection during surgery for superior and posterior AComA aneurysms.

A temporal approach to anterior communicating artery aneurysms

1989 ◽  
Vol 71 (1) ◽  
pp. 144-146 ◽  
Author(s):  
Charles E. Poletti
Keyword(s):  
Brain Tissue ◽  
Anterior Communicating Artery ◽  
Temporal Fossa ◽  
Content Type ◽  
Anterior Communicating Artery Aneurysms ◽  
Brain Retraction ◽  
Gyrus Rectus ◽  
Fine Print

✓ As an alternative to approaching anterior communicating artery (ACoA) aneurysms through the frontal fossa, either parasagittally or laterally (pterional, gyrus rectus approach), this report describes an approach to ACoA aneurysms through the temporal fossa. The main advantages of this temporal technique are that it requires less brain retraction, gives better surgical orientation, gains control of both A1 segments before disturbing the aneurysm, and involves minimal resection of brain tissue. This temporal approach has recently been used by the author in 20 consecutive operations for ACoA aneurysms in preference to the gyrus rectus approach.

Postoperative Anosmia after Anterior Communicating Artery Aneurysms Surgery by the Pterional Approach

1996 ◽  
Vol 39 (03) ◽  
pp. 71-73 ◽  
Author(s):  
I. Aydin ◽  
H. Kadioğlu ◽  
Y. Tüzün ◽  
Ç. Kayaoğlu ◽  
E. Takçi ◽  
...  
Keyword(s):  
Anterior Communicating Artery ◽  
Pterional Approach ◽  
Anterior Communicating Artery Aneurysms
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