caa a22 4500 606214208 CHVBK 20210128101051.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s00701-015-2497-2 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2497-2 The extended endoscopic endonasal transplanum transtuberculum approach to the anterior communicating artery complex: anatomic study [Elektronische Daten] [Elena d'Avella, Matteo De Notaris, Joaquim Enseñat, Joan Berenguer, Cristian Gragnaniello, Marija Mavar, Enrique Ferrer, Alberto Prats-Galino] Background: When performing a transplanum transtuberculum approach, dealing with the anterior communicating artery (ACoA) complex is inevitable. The aim of this study is to provide quantitative anatomical information regarding the ACoA complex and its bony and neural relationships, when exposed through this approach. Method: The endoscopic endonasal transplanum transtuberculum approach was performed on ten human cadaver heads. In each specimen, radiological studies were performed. A three-dimensional model of the approach was reconstructed. Measured parameters were: exposure of the vessels; distance between the proximal anterior cerebral artery (A1) and the optic chiasm; dimension of the bone opening. The feasibility to perform clip placement was graded as "possible” or "not possible”. Results: Dimension of bone opening varied from 88 to 53mm2. The ACoA was exposed for 3mm ± 2mm, A1 for 17mm ± 9mm, the distal anterior cerebral artery (A2) for 12mm ± 3mm, the recurrent artery of Heubner (RAH) for 16mm ± 4mm. Clip placement was possible on the ACoA, A2, and distal segment of A1 in all cases, and on the proximal segment of A1 in one instance. The distance between A1 and the optic chiasm measured 9mm ± 2mm. Conclusions: The ACoA, A2, and the distal segment of A1 can be visualized and controlled through the transplanum transtuberculum approach. The relationship between A1, gyrus rectus, and optic chiasm is the main determinant for the exposure and control of the vessel. The olfactory nerve can represent a surgical landmark for the identification of the A1 origin. The whole course of the RAH can be visualized trough this approach. Springer-Verlag Wien, 2015 Anatomy nationallicence Anterior communicating artery complex nationallicence Endoscopy nationallicence Transplanum transtuberculum approach nationallicence d'Avella Elena Laboratory of Surgical NeuroAnatomy (LSNA), Human Anatomy and Embryology Unit, Faculty of Medicine, Universitat de Barcelona, C/ Casanova 143, 08036, Barcelona, Spain aut De Notaris Matteo Neurosurgical Department, "G. Rummo” Hospital of Benevento, Benevento, Italy aut Enseñat Joaquim Department of Neurosurgery, Hospital Clinic, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain aut Berenguer Joan Department of Radiology, Hospital Clinic, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain aut Gragnaniello Cristian Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia aut Mavar Marija Laboratory of Surgical NeuroAnatomy (LSNA), Human Anatomy and Embryology Unit, Faculty of Medicine, Universitat de Barcelona, C/ Casanova 143, 08036, Barcelona, Spain aut Ferrer Enrique Department of Neurosurgery, Hospital Clinic, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain aut Prats-Galino Alberto Laboratory of Surgical NeuroAnatomy (LSNA), Human Anatomy and Embryology Unit, Faculty of Medicine, Universitat de Barcelona, C/ Casanova 143, 08036, Barcelona, Spain aut Acta Neurochirurgica Springer Vienna 157/9(2015-09-01), 1495-1503 0001-6268 157:9<1495 2015 157 701 https://doi.org/10.1007/s00701-015-2497-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2497-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- d'Avella Elena Laboratory of Surgical NeuroAnatomy (LSNA), Human Anatomy and Embryology Unit, Faculty of Medicine, Universitat de Barcelona, C/ Casanova 143, 08036, Barcelona, Spain aut NATIONALLICENCE 700 1- De Notaris Matteo Neurosurgical Department, "G. Rummo” Hospital of Benevento, Benevento, Italy aut NATIONALLICENCE 700 1- Enseñat Joaquim Department of Neurosurgery, Hospital Clinic, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain aut NATIONALLICENCE 700 1- Berenguer Joan Department of Radiology, Hospital Clinic, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain aut NATIONALLICENCE 700 1- Gragnaniello Cristian Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia aut NATIONALLICENCE 700 1- Mavar Marija Laboratory of Surgical NeuroAnatomy (LSNA), Human Anatomy and Embryology Unit, Faculty of Medicine, Universitat de Barcelona, C/ Casanova 143, 08036, Barcelona, Spain aut NATIONALLICENCE 700 1- Ferrer Enrique Department of Neurosurgery, Hospital Clinic, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain aut NATIONALLICENCE 700 1- Prats-Galino Alberto Laboratory of Surgical NeuroAnatomy (LSNA), Human Anatomy and Embryology Unit, Faculty of Medicine, Universitat de Barcelona, C/ Casanova 143, 08036, Barcelona, Spain aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/9(2015-09-01), 1495-1503 0001-6268 157:9<1495 2015 157 701