Document Detail

Outcomes of endovascular coiling of anterior communicating artery aneurysms in the early post-rupture period: a prospective analysis.
MedLine Citation:
PMID:  21483121     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There have been significant advances in the technical aspects of endovascular therapy of cerebral aneurysms. Anterior communicating artery (Acom A) aneurysms were traditionally treated by surgical clipping. Endovascular coiling has the distinct advantage of being minimally invasive and can be performed anytime during the course of subarachnoid hemorrhage (SAH).
AIMS: To evaluate the results of endovascular coiling of Acom A aneurysms in the early post-rupture period.
MATERIAL AND METHODS: Between June 1999 and December 2009, 103 Acom A aneurysms were treated with endovascular coiling. All the patients underwent digital subtraction angiography (DSA) and a diagnostic 3D rotational angiogram (3D-RA), followed by coiling using dedicated intracranial coils.
RESULTS: Of the 103 patients coiled, 52% presented in Fischer grade 3/4 SAH and 13.5% in Hunt and Hess grade 4/5. Technical success was 98%. Complete obliteration of the aneurysm was achieved in 97 (94%) patients. Only one patient died of direct procedure-related complication due to coil prolapse. None of the patients had rebleeds. Six-month check angiogram performed in 34 patients showed significant recanalization in one patient.
CONCLUSION: Ruptured Acom A aneurysms are implicated in majority of cases of SAH. Our results support the latest guideline "that endovascular coil occlusion of the aneurysm is appropriate for patients with a ruptured cerebral artery aneurysm that is deemed treatable either by endovascular coiling or by surgical clipping."
Mathew P Cherian; M B Pranesh; Pankaj Mehta; K Vijayan; P Baskar; Tejas M Kalyanpur; Kaustubh S Narsinghpura
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurology India     Volume:  59     ISSN:  0028-3886     ISO Abbreviation:  Neurol India     Publication Date:    2011 Mar-Apr
Date Detail:
Created Date:  2011-04-12     Completed Date:  2011-07-05     Revised Date:  2011-10-21    
Medline Journal Info:
Nlm Unique ID:  0042005     Medline TA:  Neurol India     Country:  India    
Other Details:
Languages:  eng     Pagination:  218-23     Citation Subset:  IM    
Department of Radiology, Kovai Medical Center and Hospital, Avinashi Road, Coimbatore, Tamil Nadu, India.
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MeSH Terms
Cerebral Angiography
Embolization, Therapeutic / methods*
Endovascular Procedures / methods*
Intracranial Aneurysm / complications,  radiography,  therapy*
Middle Aged
Prospective Studies
Subarachnoid Hemorrhage / etiology,  radiography,  therapy*
Treatment Outcome

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