Comment on Kitano, M. and Taneda, M.: Extended transsphenoidal approach to the anterior communicating artery aneurysm: aneurysm incidentally identified during macroadenoma resection
Kitano and Taneda describe the successful clipping of an ACoA aneurysm via the transsphenoidal approach. There are limitations of the approach; most notable are the limited and narrow corridor and the relationship between the aneurysm and the optic chiasm, which may hinder full visualization of the A1 vessels for proximal control (especially in patients with short A1 segments). The aneurysm in this case was very small and unruptured. The limitation of the transsphenoidal approach is the lack of ability to perform extensive bimanual manipulation and dissection because of the narrow corridor. A larger lesion that was superiorly directed would be much more difficult to dissect and clip using this approach.
Wolters Kluwer (LWW)
Aneurysm; Transsphenoidal approach
Nervous system -- Surgery; Aneurysms -- Surgery
Couldwell, W. T. (2007). Comment on Kitano, M. and Taneda, M.: Extended transsphenoidal approach to the anterior communicating artery aneurysm: aneurysm incidentally identified during macroadenoma resection. Neurosurgery, 61, ONSE300.