2023 Volume 51 Issue 4 Pages 292-297
Aneurysms at the proximal segment (A1) of the anterior cerebral artery are rare, accounting for 1–2% of all cerebral aneurysms. They are also known for the challenges they pose to treatment because of their proximity to the perforating arteries. In this study, we retrospectively reviewed ten cases of A1 aneurysms and reported their clinical characteristics and treatment strategies. Of the 1, 520 cases of cerebral aneurysms treated at our hospital, 10 (0.6%) were A1 aneurysms including nine unruptured and one ruptured. These aneurysms were located distal to A1 in six cases, proximal in three cases, and the middle in one case. A1 aneurysms were treated by clipping and coil embolization in four cases, and by wrapping in one case. One patient with a giant thrombosed aneurysm was treated via STA-STA-A3 bypass and trapping. There were no treatment-related complications or damage to the perforating arteries. Clipping is safe and effective in the treatment of A1 aneurysms while preserving the perforating arteries. However, endovascular treatment has been widely reported in recent years. As in the giant thrombosed A1 aneurysm case, bypass surgery is required for effective surgical management of the aneurysm.
