Anterior communicating artery aneurysm (ACOM aneurysm)
Last edit by Alaric Steinmetz on
Synonyms: ACOM Aneurysma
ICD-10: I67.10, Q28.20
Aneurysms in the Anterior communicating artery, also referred to as ACOM aneurysms, are among the most common intracranial aneurysms. The presence of an ACOM aneurysm correlates with patient age, the angle between the anterior communicating artery and the A2 segment of the Anterior cerebral artery, and a smaller vessel diameter of the ACOM complex[^1].
History
The first surgical treatments of ACOM aneurysms described in the literature were performed as early as 1933 and 1936 using Muscle wrapping [^2].
Imaging
The gold standard for visualizing aneurysms is Digital subtraction angiography. Depending on the size of the aneurysm, it may already be detected on CT angiography.
Treatment
Anterior communicating artery aneurysms can be treated microsurgically by clipping or by endovascular techniques. The treatment modality should be selected according to the aneurysm’s anatomical characteristics.
Anterior communicating artery aneurysms directed caudally and anteriorly are best suited for microsurgical treatment by clipping. Aneurysms directed superiorly or dorsally are more difficult to treat microsurgically, as control of the contralateral vessels and perforators can be more difficult to achieve[^3].
