Minimally invasive transorbital approach for anterior communicating artery aneurysms: How I do it

Walter C Jean; Franco Rubino; Peter Harris; Miguel Sàez-Alegre

doi:10.1007/s00701-025-06556-x

Minimally invasive transorbital approach for anterior communicating artery aneurysms: How I do it

Acta Neurochir (Wien). 2025 May 9;167(1):136. doi: 10.1007/s00701-025-06556-x.

Authors

Walter C Jean¹, Franco Rubino², Peter Harris³, Miguel Sàez-Alegre^{4

5

6}

Affiliations

¹ Lehigh Valley Fleming Neuroscience Institute, Allentown, PA, USA. walterjean@usf.edu.
² Lehigh Valley Fleming Neuroscience Institute, Allentown, PA, USA.
³ George Washington University, Washington, DC, USA.
⁴ Department of Neurological Surgery, Hospital General Universitario de Castellón, Castellón, Spain.
⁵ Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain.
⁶ Department of Neurological Surgery, Research Collaborator Mayo Clinic, Rochester, MN, USA.

Abstract

Background: The transorbital approach through the roof of the orbit can be utilized safely for the clip obliteration of ACOM aneurysms.

Method: We demonstrate the technique and describe the limited indications for its application. The operation proceeds by strictly following the anatomic dissection of the optic nerve, A1 segment of the ACA and then dissection and clipping of the aneurysm.

Conclusion: For the properly chosen patient and aneurysm, the transorbital approach has an excellent cosmetic outcome and can safely eliminate the aneurysm with great patient satisfaction.

Keywords: Aneurysm; Keyhole; Minimally invasive surgery.

MeSH terms

Anterior Cerebral Artery* / surgery
Humans
Intracranial Aneurysm* / diagnostic imaging
Intracranial Aneurysm* / surgery
Minimally Invasive Surgical Procedures* / methods
Neurosurgical Procedures* / instrumentation
Neurosurgical Procedures* / methods
Orbit* / surgery