Flow diversion for anterior choroidal artery (AChA) aneurysms: a multi-institutional experience
Department of Radiology
Nervous System Diseases | Neurology | Radiology
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.
aneurysm, angiography, artery, flow diverter, hemorrhage
DOI of Published Version
J Neurointerv Surg. 2017 Oct 31. pii: neurintsurg-2017-013466. doi: 10.1136/neurintsurg-2017-013466. Link to article on publisher's site
Journal of neurointerventional surgery
Srinivasan, Visish M.; Ghali, Michael George Zaki; Cherian, Jacob; Mokin, Maxim; Puri, Ajit S.; Grandhi, Ramesh; Chen, Stephen R.; Johnson, Jeremiah N.; and Kan, Peter, "Flow diversion for anterior choroidal artery (AChA) aneurysms: a multi-institutional experience" (2017). Radiology Publications and Presentations. 352.