The Modified Trapping Technique for Pericallosal Artery Fusiform Aneurysm

Area of Science:

• Neurosurgery
• Vascular Neurology
• Medical Imaging

Background:

• Distal anterior cerebral artery (ACA) aneurysms are rare, comprising 4%-5% of intracranial aneurysms.
• Complex distal ACA aneurysms often resist standard clipping or endovascular treatments.
• Alternative surgical strategies are needed for these challenging cases.

Purpose of the Study:

• To describe a modified trapping technique for distal ACA aneurysms with two non-sacrificeable branches.
• To demonstrate the feasibility and safety of this technique in a clinical case.

Main Methods:

• A modified surgical trapping technique involving branch transposition and reimplantation.
• Exclusion of the aneurysm via clipping after preserving anterograde blood flow.
• Application of the technique in a patient with a fusiform distal ACA aneurysm.

Main Results:

• The modified technique successfully excluded the aneurysm.
• Postoperative imaging confirmed patency of both non-occluded and reimplanted pericallosal arteries.
• The procedure prevented potential parent artery thrombosis associated with complete trapping.

Conclusions:

• The described modified trapping technique is a viable alternative for complex distal ACA aneurysms.
• This method effectively preserves cerebral perfusion to critical territories.
• It offers a safe and effective solution when standard treatments are not feasible.