Title

Flow diversion for anterior choroidal artery (AChA) aneurysms: a multi-institutional experience

UMMS Affiliation

Department of Radiology

Publication Date

2017-10-31

Document Type

Article

Disciplines

Nervous System Diseases | Neurology | Radiology

Abstract

BACKGROUND: Anterior choroidal artery (AChA) aneurysms represent a small subset of cerebral aneurysms. The Pipeline Embolization Device (PED) has been successfully applied to various aneurysms of the supraclinoid internal carotid artery (ICA). The treatment of these aneurysms requires special attention due to the eloquent territory supplied by the AChA. We report the largest and first dedicated series of flow diversion treatment of AChA aneurysms.

METHODS: Four institutional neurointerventional databases were reviewed for cases of intracranial aneurysms treated with PED. Patient and aneurysm data as well as angiographic imaging were reviewed for all cases of AChA aneurysms treated with PED. AChA aneurysms were defined as aneurysms distal to the AChA and proximal to the ICA terminus, with or without the incorporation of the AChA.

RESULTS: Eighteen AChA aneurysms were treated during the study period. All aneurysms were successfully treated with a mean follow-up of 19.1 months. The large majority of aneurysms (15/18, 83.3%) were completely obliterated. No patients suffered from intra- or post-procedural complications. A1 stenosis was a common occurrence, seen in 10 of 16 (62.5%) covered anterior cerebral arteries (ACAs), although all were asymptomatic. All AChAs remained patent at last follow-up.

CONCLUSIONS: The PED can be used successfully in AChA aneurysms with a good safety and efficacy profile. All AChAs remained patent. Collateral flow networks, especially for the ACA, affect long-term branch vessel patency. Treatment with PED for AChA aneurysms appears to be a reasonable option to consider and should be evaluated in a larger cohort.

Keywords

aneurysm, angiography, artery, flow diverter, hemorrhage

DOI of Published Version

10.1136/neurintsurg-2017-013466

Source

J Neurointerv Surg. 2017 Oct 31. pii: neurintsurg-2017-013466. doi: 10.1136/neurintsurg-2017-013466. Link to article on publisher's site

Journal/Book/Conference Title

Journal of neurointerventional surgery

Related Resources

Link to Article in PubMed

PubMed ID

29089414

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