J Korean Neurosurg Soc.  2008 Mar;43(3):131-134. 10.3340/jkns.2008.43.3.131.

Analysis of Clip-induced Ischemic Complication of Anterior Choroidal Artery Aneurysms

• Cho MS
• Kim MS
• Chang CH
• Kim SW
• Kim SH
• Choi BY

• KMID: 2067318
• DOI: http://doi.org/10.3340/jkns.2008.43.3.131

Abstract

OBJECTIVE
The surgical approach is typically similar to those used for other supraclinoid internal carotid artery (ICA) lesions. However, the surgical clipping of this aneurysm is complicated and as a result, can result in postoperative ischemic complications. We studied to clarify the clip-induced ischemic complication risk of AChA aneurysm and to get the benefits for helping decision making.
METHODS
We retrospectively investigated 53 cases (4.0%) of AchA aneurysm treated surgically. We divided the AChA aneurysm to 3 subtype according to the origin of aneurysmal neck; A type originating from the AChA itself, J type from junction of AChA and ICA, and I type from the ICA itself. We evaluated brain CT about 1 week post-operative day to confirm the low density in AChA territory.
RESULTS
Ruptured aneurysm was 26 cases and unruptured aneurysm 27 cases. The aneurysmal subtype of A, J, and I was 13, 17, and 23 cases. Of the 53 cases who performed surgical neck clipping, twelve (22.6%) had postoperative AChA distribution infarcts. Increased infarct after neck clipping had statistic significance in non-I subtype (p=0.005).
CONCLUSION
It is easy to classify as "easy" surgery. But surgery for AChA aneurysms carries with it a significant risk of postoperative stroke. Don't always stick to clipping only, especially in non-I type of incidental small aneurysm, which has high risk of post-clip ischemic complications.

Keyword

Anterior choroidal artery infarction; Clip; Intracranial aneurysm

MeSH Terms

Adenosine
Aneurysm
Aneurysm, Ruptured
Arteries
Brain
Carotid Artery, Internal
Cerebral Infarction
Choroid
Decision Making
Intracranial Aneurysm
Neck
Retrospective Studies
Stroke
Surgical Instruments
Adenosine