Endovascular treatment of A1 aneurysms of the anterior cerebral artery.

Abstract

AIM:

The aim of this study was to present the clinical and angiographic outcomes of A1 aneurysms treated by coil embolization.

MATERIALS AND METHODS:

We retrospectively evaluated 38 consecutive patients with A1 aneurysm (20 ruptured and 18 unruptured; mean age, 53.8 ± 11.9 years) from 2011 to 2014 treated by an endovascular approach in our hospital. Follow-up angiography was obtained in 30 patients. Clinical outcomes were evaluated by modified Rankin Scale (mRS) over telephone.

RESULTS:

Among the 38 patients, 24 were treated with single-catheter technique, 8 with stent-assisted coiling (Enterprise 3; Solitaire 5), 5 with parent vessel obliteration, and 1 with balloon-assisted coiling. Initial angiographic results revealed that complete occlusion was achieved in 21 aneurysms (55.3%), near-complete occlusion in 16 (42.1%), and partial occlusion with contrast agent filling the aneurysm sac in 1 (2.6%). Procedure-related complications were observed in 6 patients (15.8%). Follow-up angiographic imaging evaluation after coil embolization was performed in 32 aneurysms (mean interval, 22.6 ± 6.7 months), which showed that 31 (96.9%) aneurysms remained stable or improved without regrowth, while minor recanalization was found in 1 aneurysm (3.1%), which was treated by parent vessel occlusion. Clinical follow-up evaluation was excellent in 37 of the 38 patients (mRS score 0 in 34, and mRS score 1 in 3) at a mean duration of 26.6 ± 7.7 months.

CONCLUSIONS:

Endovascular treatment is feasible and effective for A1 segment aneurysms. The current treatment selections, including single-catheter embolization, balloon-assisted coiling, stent-assisted coiling, and parent vessel occlusion, should be performed according to the characteristics and morphology of A1 aneurysms.

• Authors: Peng Liu, Xianli Lv, Youxiang Li, Ming Lv
• Journal: Neurology India (Neurol India) 2016 Jul-Aug Vol. 64 Issue 4 Pg. 694-700 ISSN: 0028-3886 [Print] India
• PMID: 27381117 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Anterior Cerebral Artery
• Blood Vessel Prosthesis
• Embolization, Therapeutic (methods)
• Female
• Humans
• Intracranial Aneurysm (therapy)
• Male
• Middle Aged
• Retrospective Studies
• Stents
• Treatment Outcome