Commentary “Anterior Communicating Artery Aneurysm Surgery through the Orbitopterional Approach: Long-Term Follow-Up in a Series of 75 Consecutive Patients”

The authors report their series of 75 patients who underwent an orbitopterional approach for clipping of anterior communicating artery aneurysms. They demonstrate excellent results with good follow-up, making evident their significant surgical expertise. At the Barrow Neurological Institute, we also approach all ACoA aneurysms via a modified orbitozygomatic approach. In fact, we use this approach as the workhorse for exposing all circle of Willis aneurysms. We agree with the authors that the additional removal of bone in this skull base approach avoids significant brain retraction during surgery and hence improves overall outcome.