{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T17:15:43Z","timestamp":1788628543862,"version":"build-2803163510"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2014,6]]},"abstract":"\n Object<\/jats:title>\n The authors describe their experience with intracranial-to-intracranial (IC-IC) bypasses for complex anterior cerebral artery (ACA) aneurysms with giant size, dolichoectatic morphology, or intraluminal thrombus; they determine how others have addressed the limitations of ACA bypass; and they discuss clinical indications and microsurgical technique.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A consecutive, single-surgeon experience with ACA aneurysms and bypasses over a 16-year period was retrospectively reviewed. Bypasses for ACA aneurysms reported in the literature were also reviewed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ten patients had aneurysms that were treated with ACA bypass as part of their surgical intervention. Four patients presented with subarachnoid hemorrhage and 3 patients with mass effect symptoms from giant aneurysms; 1 patient with bacterial endocarditis had a mycotic aneurysm, and 1 patient's meningioma resection was complicated by an iatrogenic pseudoaneurysm. One patient had his aneurysm discovered incidentally. There were 2 precommunicating aneurysms (A\n 1<\/jats:sub>\n segment of the ACA), 5 communicating aneurysms (ACoA), and 3 postcommunicating (A\n 2<\/jats:sub>\n \u2013A\n 3<\/jats:sub>\n segments of the ACA). In situ bypasses were used in 4 patients (A\n 3<\/jats:sub>\n -A\n 3<\/jats:sub>\n bypass), interposition bypasses in 4 patients, reimplantation in 1 patient (pericallosal artery-to-callosomarginal artery), and reanastomosis in 1 patient (pericallosal artery). Complete aneurysm obliteration was demonstrated in 8 patients, and bypass patency was demonstrated in 8 patients. One bypass thrombosed, but 4 years later. There were no operative deaths, and permanent neurological morbidity was observed in 2 patients. At last follow-up, 8 patients (80%) were improved or unchanged. In a review of the 29 relevant reports, the A\n 3<\/jats:sub>\n -A\n 3<\/jats:sub>\n in situ bypass was used most commonly, extracranial (EC)\u2013IC interpositional bypasses were the second most common, and reanastomosis and reimplantation were used the least.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Anterior cerebral artery aneurysms requiring bypass are rare and can be revascularized in a variety of ways. Anterior cerebral artery aneurysms, more than any other aneurysms, require a thorough survey of patient-specific anatomy and microsurgical options before deciding on an individualized management strategy. The authors' experience demonstrates a preference for IC-IC reconstruction, but EC-IC bypasses are reported frequently in the literature. The authors conclude that ACA bypass with indirect aneurysm occlusion is a good alternative to direct clip reconstruction for complex ACA aneurysms.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2014.3.jns132219","type":"journal-article","created":{"date-parts":[[2014,4,18]],"date-time":"2014-04-18T10:28:16Z","timestamp":1397816896000},"page":"1364-1377","source":"Crossref","is-referenced-by-count":96,"title":["Anterior cerebral artery bypass for complex aneurysms: an experience with intracranial-intracranial reconstruction and review of bypass options"],"prefix":"10.3171","volume":"120","author":[{"given":"Adib A.","family":"Abla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Lawton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns132219","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"185","DOI":"10.3171\/jns.1996.84.2.0185","article-title":"Characteristics and surgical treatment of dolichoectatic and fusiform aneurysms","volume":"84","author":"Anson","year":"1996"},{"key":"b2-jns132219","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.3171\/jns.2002.97.5.1029","article-title":"Excimer laser-assisted bypass in aneurysm treatment: short-term outcomes","volume":"97","author":"Brilstra","year":"2002"},{"key":"b3-jns132219","series-title":"World Neurosurg","article-title":"Surgical techniques for unclippable fusiform A2-anterior cerebral artery aneurysms and description of a frontopolar-to-A2 bypass","author":"Chen","year":"2012"},{"issue":"1 Suppl Operative","key":"b4-jns132219","series-title":"Neurosurgery","first-page":"4","article-title":"The contralateral transcingulate approach: operative technique and results with vascular lesions","volume":"71","author":"Davies","year":"2012"},{"key":"b5-jns132219","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"444","DOI":"10.3171\/2012.11.JNS121061","article-title":"The Y-shaped double-barrel bypass in the treatment of large and giant anterior communicating artery aneurysms. 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