Neurointervention.  2013 Sep;8(2):87-91. 10.5469/neuroint.2013.8.2.87.

Endovascular Coil Embolization of Distal Anterior Cerebral Artery Aneurysms: Angiographic and Clinical Follow-up Results

Affiliations
  • 1Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. nskwon.sc@gmail.com
  • 2Biomedical Research Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Abstract

PURPOSE
This study is an overview of the clinical and angiographic outcomes of patients who undergo treatment for distal anterior cerebral artery aneurysms.
MATERIALS AND METHODS
Between January 2009 and March 2012, 444 cerebral aneurysms were treated using endovascular coil embolization at our institute. Among them, 217 aneurysms were followed-up with angiography at least six months later. Of these, there were 16 distal anterior cerebral artery (ACA) aneurysms in 16 patients. We conducted a retrospective review of clinical and radiological follow-up results of all patients with distal ACA aneurysms. The clinical and angiographic outcomes were assessed using the modified Rankin scale (mRS) and the Raymond classification scale, respectively.
RESULTS
The mean age was 54.7 +/- 10.2 years (41-75 years). The mean follow-up period was 20.6 +/- 9.64 months (6-37 months). Three patients presented with acute rupture. The average aneurysm size was 4.98 +/- 1.39 mm (3.0-8.1 mm), and eight of 16 aneurysms (50%) had aspect ratios < 2.0. All 16 patients presented with complete obliteration immediately after the procedure. However, two patients had procedure-related complications, one with coil extrusion to the subarachnoid space without hemorrhage and one with thromboembolism subsequent to chemical thrombolysis. In the follow-up angiography, one major and five minor recurrences (for a total of six recurrences, 37.5%) were detected. However, the differences between the ACA aneurysm group and others were not statistically significant. Clinical outcomes were good for all of the patients at the time of discharge (mean mRS: 0.25, 0 to 1) and at the follow-ups (mean mRS: 0).
CONCLUSION
Despite a comparatively high recurrence rate, the endovascular treatment of distal anterior cerebral aneurysms is feasible and has a good clinical outcome.

Keyword

Distal anterior cerebral artery; Aneurysm; Endovascular coil embolization; Recurrence

MeSH Terms

Aneurysm
Angiography
Anterior Cerebral Artery
Follow-Up Studies
Hemorrhage
Humans
Intracranial Aneurysm
Recurrence
Retrospective Studies
Rupture
Subarachnoid Space
Thromboembolism

Cited by  1 articles

Endovascular Treatment of Ruptured Pericallosal Artery Aneurysms
Jun Kyeung Ko, Hwan Soo Kim, Hyuk Jin Choi, Tae Hong Lee, Eun Young Yun, Chang Hwa Choi
J Korean Neurosurg Soc. 2015;58(3):197-204.    doi: 10.3340/jkns.2015.58.3.197.


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