Angiographic Characteristics and Endovascular Treatment of Anterior Cerebral Artery A1 Segment Aneurysms

World Neurosurg. 2017 Jan:97:551-556. doi: 10.1016/j.wneu.2016.08.117. Epub 2016 Sep 5.

Abstract

Objective: This report aimed to review the angiographic characteristics and evaluate the safety and feasibility of endovascular treatment of A1 aneurysms.

Methods: Nineteen ruptured and 13 unruptured A1 aneurysms treated endovascularly were evaluated in this study. The angiographic and clinical records were retrospectively reviewed.

Results: Endovascular treatments were successfully applied in all 32 aneurysms. Conventional coiling was performed in 24 aneurysms, stent-assisted coiling in 7, and solo stenting in 1. The immediate angiographic result was 1 aneurysm in 15, two aneurysms in 10, and 3 in 7 aneurysms according to the Raymond grade. Intraoperative rupture was detected in 1 case without clinical consequence, and no other procedure-related complication occurred. Angiographic follow-up (mean, 12 months; range, 2-42 months) of 25 aneurysms showed total occlusion in 20, improvement in 1, stability in 3, and recurrence in 1. The only recurrence was detected in a case treated using conventional coiling, and it was retreated with stent-assisted coiling. Clinical follow-up (mean, 25 months; range, 6-93 months) was available in 24 of 30 patients, and the modified Rankin Scale score was 0-1 in 22 patients.

Conclusions: Endovascular treatment is technically feasible and safe for A1 aneurysms.

Keywords: A1 aneurysm; Anterior cerebral artery; Endovascular treatment; Stent-assisted coiling.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Cerebral Angiography*
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / surgery*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Stents*
  • Treatment Outcome