J Korean Neurosurg Soc.  2011 May;49(5):257-261. 10.3340/jkns.2011.49.5.257.

The Efficacy of Simultaneous Bilateral Internal Carotid Angiography during Coil Embolization for Anterior Communicating Artery Aneurysms

• Kwon SC
• Park JB
• Shin SH
• Sim HB
• Lyo IU
• Kim Y

• KMID: 1442574
• DOI: http://doi.org/10.3340/jkns.2011.49.5.257

Abstract

OBJECTIVE
Successful coil embolization of anterior communicating (A-com) artery aneurysms requires good visualization and understanding of the entire H complex. Bilateral carotid angiography may optimize anatomical understanding and visualization of the H complex. We therefore assessed the efficacy of simultaneous bilateral internal carotid angiography during coil embolization for A-com artery aneurysms.
METHODS
Of the 153 patients with intracranial saccular aneurysms who underwent embolization between July 2008 and December 2009, 12 had A-com artery aneurysms and were embolized under bilateral carotid angiography. Patients were evaluated angiographically, immediately and 6 months (n=11) after embolization, using a 3-point scale (complete, residual neck, residual aneurysm). The safety, performance and efficacy of this approach were retrospectively evaluated.
RESULTS
In all patients, bilateral internal carotid artery angiography provided more detailed anatomical information and understanding around the A-com artery, and, in complex situations, it allowed for more effective coil embolization through bilateral routes to the A-com artery. Angiography immediately after embolization showed occlusion of 11 of the 12 (92%) aneurysms, with none of these 11 showing evidence of recanalization at 6 months.
CONCLUSION
These findings indicate that simultaneous bilateral carotid angiography during coil embolization of selected complex A-com artery aneurysms provided improved anatomical understanding, and resulted in more effective and safer procedures than typical unilateral angiography.

Keyword

Coil embolization; A-com artery; Aneurysm; Bilateral carotid angiography

MeSH Terms

Aneurysm
Angiography
Arteries
Carotid Artery, Internal
Humans
Intracranial Aneurysm
Neck
Retrospective Studies