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Updated: Jul 12, 2026
11:58
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
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Correlation Between Aneurysm Dome Direction and Patient Outcomes Following Surgery for Ruptured Anterior
Ashis Patnaik1, Jaidev S1, Arunkumar Sekar1
1Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
Cureus
|November 30, 2023
Summary
Surgical clipping of anterior communicating artery aneurysms is durable. Aneurysm dome direction did not significantly correlate with postoperative complications, though superior projections showed fewer intraoperative ruptures.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Radiology
Background:
- Anterior communicating (Acom) artery aneurysms are the most common intracranial aneurysms.
- Open surgical clipping is the most durable treatment for Acom aneurysms.
- The impact of aneurysm dome direction on surgical outcomes is not well-defined.
Purpose of the Study:
- To analyze the correlation between aneurysm dome direction and patient outcomes after surgical clipping of ruptured Acom artery aneurysms.
Main Methods:
- Retrospective and prospective data collection from 48 patients undergoing surgery for ruptured Acom aneurysms.
- Preoperative CT angiography used for all patients.
- Analysis of preoperative, intraoperative, and postoperative variables in relation to aneurysm dome direction.
Main Results:
- No statistically significant association found between aneurysm dome direction and postoperative complications (p=0.93).
- Superiorly projecting aneurysms had the lowest rate of intraoperative rupture.
- Outcomes were influenced by dome projection over a three-month follow-up.
Conclusions:
- Aneurysm dome projection did not significantly impact postoperative complication rates in this cohort.
- Superiorly oriented aneurysms demonstrated a lower incidence of intraoperative rupture.
- Further investigation is warranted to fully understand the influence of dome projection on Acom aneurysm management.
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