Open AccessKissing anterior communicating artery aneurysms: Diagnostic dilemma and management issues
Author(s) -
S. S. Baldawa,
Girish Me,
Suresh Nair
Publication year - 2011
Publication title -
journal of postgraduate medicine/journal of postgraduate medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.405
H-Index - 52
eISSN - 0972-2823
pISSN - 0022-3859
DOI - 10.4103/0022-3859.74288
Subject(s) - medicine , clipping (morphology) , anterior communicating artery , radiology , aneurysm , clips , surgery , philosophy , linguistics
Kissing aneurysms are unusual and relatively rare types of multiple intracranial arterial aneurysms. When located on the anterior communicating artery (ACoA), kissing aneurysms pose considerable diagnostic difficulty on preoperative conventional angiogram. Special angiographic views or 3D rotational angiogram are needed to make the correct diagnosis and to avoid interpreting them as multilobed or bilobed saccular aneurysms on preoperative conventional angiogram. Treatment of these aneurysms, either by clipping or coiling, needs to be individualized. Unique problems which need to be addressed during surgical clipping are high risk of rupture due to dense adhesions between the kissing aneurysms, requirement of at least two clips in a narrow working area, the aneurysm that needs to be clipped first and interference of the first clip with application of subsequent clips. The authors present a case of a 63-year-old male who had kissing ACoA aneurysms managed successfully by clipping.