Document Detail


Endovascular treatment of distal anterior cerebral artery aneurysms: technical results and review of the literature.
MedLine Citation:
PMID:  19018950     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We sought to report our technical success and complications in treating distal anterior cerebral artery (ACA) aneurysms with coil embolization. METHODS: We retrospectively reviewed all patients undergoing coil embolization of distal ACA aneurysms from September 1999 to March 2008. Patients were assessed for subarachnoid hemorrhage, fundus size, and fundus-to-neck ratio (F/N) < 2 or >or= 2. Technical success for aneurysms was assessed according to established criteria immediately post-procedure and at 6-month angiographic follow-up. Post-procedural outcomes were measured using the modified Rankin Scale (mRS) at discharge. A mRS <or= 2 for ruptured aneurysms or no change from baseline for unruptured aneurysms was considered a good clinical outcome. RESULTS: Based on an intention-to-treat principle, we attempted embolization of 28 distal ACA aneurysms in 26 patients and were technically successful in 26 aneurysms (93%). Our mean age was 58 +/- 11 years. Thirteen presented with acute rupture. Average aneurysm size was 5.7 +/- 2.8 mm in our cohort with 20/28 (71%) having an F/N >or= 2. Seventeen aneurysms with an F/N >or= 2 and 5 with an F/N < 2 were completely obliterated or had minimal neck remnants at the end of the procedure (79%). Fourteen aneurysms underwent 6-month angiographic follow-up and were either completely obliterated or had a minimal residual neck remnant. Clinical outcomes were good in 12/13 unruptured patients (93%) at the time of discharge and in 6/13 ruptured patients (46%) with 90-day follow-up. Three patients had ischemic complications that were considered non-disabling, and 2 patients died from complications related to their initial subarachnoid hemorrhage. Two patients had an aborted procedure from failure to catheterize the aneurysm. CONCLUSION: Endovascular treatment of distal ACA aneurysms can achieve good technical and clinical outcomes.
Authors:
Nirav Vora; Ajith J Thomas; Rishi Gupta; Yakov Gologorsky; Narendra Panapitiya; Tudor Jovin; Brian Jankowitz; Amin Kassam; Michael Horowitz
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  20     ISSN:  1552-6569     ISO Abbreviation:  J Neuroimaging     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-09-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  70-3     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anterior Cerebral Artery / pathology
Cerebral Angiography
Cohort Studies
Embolization, Therapeutic / methods*
Female
Follow-Up Studies
Humans
Intracranial Aneurysm / pathology,  therapy*
Male
Middle Aged
Registries
Retrospective Studies
Severity of Illness Index
Subarachnoid Hemorrhage / drug therapy,  pathology
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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