What Is the Anterior Communicating Artery?

The anterior cerebral artery is located on the outside of the optic cross, and is sent from the internal carotid artery forward at a near right angle. The anterior communication artery is connected by the lateral branches between the left and right anterior cerebral arteries. The anterior communicating artery is an important part of the Willis ring at the base of the brain. It is a common site of intracranial aneurysms and an important structure for tumors in the saddle area.

The anterior cerebral artery is located on the outside of the optic cross, and is sent from the internal carotid artery forward at a near right angle. The anterior communication artery is connected by the lateral branches between the left and right anterior cerebral arteries. The anterior communicating artery is an important part of the Willis ring at the base of the brain. It is a common site of intracranial aneurysms and an important structure for tumors in the saddle area.

Chinese name

Anterior communicating artery

Foreign name

anteriorcommunicatingartery

Anatomy of anterior communicating artery

1. The anterior communicating artery is located just below the anterior optic cross, and is a short trunk connected to the anterior segment of the anterior cerebral artery of varying sizes on both sides. There are many variations, which can be divided into simple types and complex types according to the shape. The former is connected to the bilateral anterior cerebral arteries, which accounts for 45% to 80%, and the latter has two, three, Y, O, Various shapes, such as mesh type and window. A small number of people have bilateral anterior cerebral artery fusion and anterior communicating artery is absent, about 4.5%.

2. The anterior communicating artery is located above the optic cross, adjacent to the endplate. Most anterior communicating arteries are located in front of or above the endplate, and there are still slender trabecular fibers connected between the anterior communicating artery and the endplate in the endplate pool. Therefore, in the clinical process, it is necessary to carefully separate the adhesion sharply, and then push the anterior communicating artery upward and backward, and pay attention to protecting the hypothalamus perforating artery until the end plate is exposed satisfactorily. When the anterior communicating artery is bifurcated, tribranched, or reticulated, the end-plate approach can be restricted. The anterior communicating artery hypothalamus perforating artery often starts from the superior, posterior, and inferior walls of the anterior communicating artery. Some researchers have divided the perforating branch blood vessels into three types according to the distribution area: inferior iliac branch: it starts from the posterior superior wall of the anterior communicating artery and is thicker than other perforating branches. It is the most important perforating branch of the anterior communicating artery. It branches to the hypothalamus area, and the blood supply range involves the endplate, the anterior hypothalamus, the anterior commissure, the anterior cingulate gyrus, the mouth and knee of the corpus callosum. Hypothalamic branch: It usually starts from the posterior and inferior part of the anterior communicating artery and supplies the hypothalamic area, which coincides with the inferior phrenic branch. Optic cross branch: The incidence is low, and it supplies the front of the optic cross and the dorsal side of the optic nerve. Some researchers believe that 95% of the perforating branches are sent from the anterior communicating artery and do not reach the anterior wall of the third ventricle without the endplate, but directly enter the hypothalamus and the optic cross section.

Anterior communication artery related diseases and treatment:

1. The anterior communicating artery is a common site for intracranial aneurysms. The incidence of aneurysms accounts for about 30% of the incidence of intracranial aneurysms. Because the anterior communication artery has many variations in normal human anatomy, and the location of aneurysms in this area is variable, the anatomy of surrounding tissues is more complicated, which brings a lot of difficulties to the clinical treatment of aneurysms in this area.

2. Surgical treatment: Different treatment measures should be taken for anterior communicating artery aneurysms according to specific conditions. Surgical clipping is an important method for treating anterior communicating aneurysms. Some researchers believe that the surgical treatment of anterior communication aneurysms mainly depends on the morphology and growth direction of the aneurysm. The tumor that grows forward should be treated with surgical clamping; the tumor that grows backward should be treated with intravascular.

It was found through surgery that the aneurysm of the anterior communication aneurysm grows more easily, especially when the tumor points forward and downward, and the aneurysm is observed to grow on the opposite side of the tumor-bearing artery from an orthophoto. The frontal lobe can expose the aneurysm and neck of the aneurysm, and it is easier to expose the A1 and A2 segments of the aneurysm and the contralateral anterior cerebral artery; this type of aneurysm often grows forward and downward, compressing the optic nerve, and avoid injury during separation Optic nerve and its supplying arteries. If the optic nerve is severely compressed, the aneurysm should be resected after the aneurysm is clamped, and the optic nerve should be decompressed. This type of aneurysm surgery is effective,

The anterior communication aneurysm growing forward and upward is not ideal for aneurysm exposure during the wing point approach. Sometimes a small part of the frontal lobe is removed straight back to expose the aneurysm. The anterior segment of the anterior cerebral artery of this type of aneurysm is underexposed. It is easy to damage the contralateral Heubner artery, and may cause stenosis of the A2 segment of the contralateral anterior cerebral artery when clamping the aneurysm. Therefore, the condition of the A2 segment of the contralateral anterior cerebral artery should be explored after the aneurysm is clamped. For stenosis, the aneurysm clip should be adjusted. During the operation, it should be noted that the range of the straight frontal resection should not exceed 1.5cm, and the separation of the A2 segment of the contralateral anterior cerebral artery should be minimized to prevent the occurrence of vasospasm. Care should be taken to avoid the A2 segment of the contralateral anterior cerebral artery when clamping the aneurysm. Side damage.

Modified pterygium approach for aneurysm clipping. After successful general anesthesia, drainage was placed in the large lumbar cistern, the craniotomy was opened, the dura mater was opened, and the fluid was drained along each cerebral cistern. After the brain tissue collapsed satisfactorily, the ipsilateral anterior cerebral artery A1 segment, anterior communicating artery, A1 segment of the lateral anterior cerebral artery and A2 segment of the bilateral anterior cerebral artery protect the recurrent artery, expose the aneurysm, and separate the aneurysm neck. If the aneurysm body points forward and upward, it is difficult to directly expose the aneurysm, and sometimes a small part of the frontal lobe is removed. Straight back (about 1cm in diameter), select the appropriate aneurysm clip to clamp the aneurysm.

Anterior communication artery attention

When performing anterior communication aneurysm rupture and clipping, care should be taken to identify the perforating branch of the anterior communicating artery, and strive to retain important structures such as the inferior sacral branch; while damage to the hypothalamic branch, water and electrolyte disorders and high fever may also occur , Cognitive impairment and long-term coma should be identified and protected. For the small perforating branch of the superior optic cross artery from the anterior communicating artery to the surface of the optic cross, because these small perforating branches are rich in anastomosis with the optic branch of the superior pituitary artery, they are cut off if necessary, and there is generally no serious clinical disease after surgery. Symptoms: However, after the anterior communication aneurysm ruptures, its blood supply vessels spasm and cause ischemia. If care is not taken to protect the superior optic cross artery during surgery, it may also cause vision loss and visual field loss.