Outcome of microsurgical clipping of anterior communicating aneurysms: A single-centre experience

Anterior communicating (ACOM) aneurysms are the most common intracranial aneurysms. About 30%–40% of ruptured intracranial aneurysms are ACOM aneurysms. Its complex structural and anatomical variability and its critical location pose a great challenge to the surgeon during microsurgical clipping. We share our experience in clipping these aneurysms and its outcome. The aim was to study the outcome following microsurgical clipping of ACOM artery aneurysm presenting with rupture and subarachnoid haemorrhage and to determine the factors which dictate the clinical outcome after 6 months. The study includes all cases of ruptured ACOM aneurysms who underwent microsurgical clipping between the period of 2016 and 2020. The medical records were analysed retrospectively and results were recorded. The study shows that the outcome of the patients depends on presenting World Federation of Neurological Surgeons grade, anterosuperiorly projecting aneurysms are at high risk for intraoperative rupture and complications such as lacunar infarcts are common with the usage of temporary clips.