Importance of Preoperative Vertical Geometric Analysis in Surgery for Anterior Communicating Artery Aneurysm

Gökhan Gürkan; Murat Atar

doi:10.7759/cureus.41322

Importance of Preoperative Vertical Geometric Analysis in Surgery for Anterior Communicating Artery Aneurysm

Cureus. 2023 Jul 3;15(7):e41322. doi: 10.7759/cureus.41322. eCollection 2023 Jul.

Authors

Gökhan Gürkan¹, Murat Atar²

Affiliations

¹ Department of Neurosurgery, Izmir Katip Çelebi University Atatürk Training and Research Hospital, Izmir, TUR.
² Department of Neurosurgery, Sultan Abdülhamid Han Training and Research Hospital, Istanbul, TUR.

Abstract

Objective: In this study, we analyzed the vertical geometry of the anterior communicating artery (AComA) complex with the aim to improve the surgical site orientation during aneurysm operations. Further, the geometric data that can contribute to the success of the surgical technique applied for AComA aneurysms are reported.

Methods: Computed tomography angiography data of the cerebral arteries of 100 patients who visited our clinic were analyzed. A three-dimensional examination was performed according to the Frankfurt horizontal plane (FHP) using the RadiAnt DICOM Viewer (Medixant, Poznan, Poland), and vertical measurements of the AComA complex were calculated.

Results: The Willis polygon values were found to be consistent with those in the literature. The mean height of the AComA complex was 30.58 ± 4.80 mm according to the FHP.

Conclusions: Preoperative evaluation of the vertical geometry of the AComA complex is essential for AComA aneurysm surgery. The height of the AComA complex is a key parameter affecting intraoperative surgical site visibility. Preoperative calculation of the height of the AComA complex relative to FHP can facilitate intraoperative surgical site orientation.

Keywords: anterior communicating artery; cerebral aneurysm; frankfurt horizontal plane; gyrus rectus; skull base surgery.