Treatment of complex ruptured anterior communicating arterial aneurysms by endovascular coil embolisation of the anterior communicating artery

被引:5
|
作者
Fang, Chun [1 ,2 ]
Li, Ming-Hua [1 ]
Zhu, Yue-Qi [1 ]
Tan, Hua-Qiao [1 ]
Zhang, Pei-Lei [1 ]
Wang, Jue [1 ]
机构
[1] Shanghai Jiao Tong Univ, Dept Radiol, Affiliated Peoples Hosp 6, Sch Med, Shanghai 200030, Peoples R China
[2] Affiliated Tong Ji Univ, Shanghai E Hosp, Dept Radiol, Shanghai, Peoples R China
关键词
Anterior communicating artery; aneurysm; coil; endovascular treatment; PERFORATING BRANCHES; FEASIBILITY; ANATOMY;
D O I
10.3109/02688697.2010.546898
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose. The current study evaluates the feasibility and safety of coil embolisation of the anterior communicating artery (ACoA) for the treatment of complicated anterior communicating arterial aneurysms (ACoAAs). Methods and materials. Five patients presented with a subarachnoid haemorrhage caused by a ruptured ACoAA. The ACoAA morphologies were well defined by three-dimensional digital subtraction angiography (3D-DSA) and magnetic resonance angiography (MRA). Two of the ACoAAs were tiny (<3 mm in diameter), and the remaining three ACoAAs were small (3-5 mm in diameter). All of the aneurysms were localised to the ACoA. The projection of the aneurysm dome was defined as being oriented superiorly or posteriorly in all five aneurysms. We performed a superselective catheterisation of each aneurysm, and we subsequently performed coil embolisation with balloon, stent or microcatheter assistance. Angiography and clinical follow-up occurred 3-6 months after the procedure. Clinical follow-up data were collected and retrospectively analysed, and patient responses were categorised as fully recovered, improved, unchanged or aggravated. Results. All five patients with ACoAA were treated successfully using coil embolisation. In three patients, both the aneurysm sac and the ACoA were embolised using coils, and in two patients, only the ACoA was embolised. Acute angiography showed occlusion of the aneurysm and ACoA. Follow-up angiography confirmed complete occlusion of the aneurysm sac, and no ACoAA recurrence was detected in any of the patients. In clinical follow-up visits, none of the patients had haemorrhaged or had a stroke. Conclusion. Combined coil embolism of the aneurysm sac and the ACoA could be a feasible and safe method for the treatment of complicated ACoAAs without bilateral aplasia of the A1 segment.
引用
收藏
页码:591 / 595
页数:5
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