Endovascular Treatment of Ruptured Anterior Communicating Artery Aneurysms

Abstract

The aim of this paper is to provide a review of our experience in using the endovascular treatment of ruptured anterior communicating artery (ACoA) aneurysms. Between March 1997 and May 2004, 211 ruptured aneurysms were treated with Guglielmi detachable coil (GDC) system in Mito Medical Center, 73 were located at the ACoA. Two cases were incomplete embolization, and performed microsurgical clipping. In the initial embolization for the 71 aneurysms, complete occlusion was achieved in 44 aneurysms, neck remnant in 11 aneurysms and body filling in 16 aneurysms. Intra-operative complication was occurred in six cases (8.2%).

Aneurysm perforation was occurred in three cases (4.1%), thromboembolic complication was occurred in three cases (4.1%). Acute rebleeding were observed in two cases (2.7%). Endovascular treatment is an effective technique for treating ACoA aneurysms, and 3D-rotational angiography is important diagnostic tool for evaluating the ACoA complex.

Keywords

anterior communicating artery aneurysm Guglielmi Detachable Coil subarachnoid haemorrhage

Get full access to this article

View all access options for this article.

References

Anxionnat

Bracard

: Intracranial aneurysms: Clinical value of 3D digital subtraction angiography in the therapeutic decision and endovascular treatment. Radiology 218: 799–808, 2001.

International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group: International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomized trial. Lancet 360: 1267–1274, 2002.

Matsumaru

Sonobe

: Rupture of aneurysms during and after embolization with Guglielmi detachable coils. Interventional Neuroradiology 7 (Suppl 1): 83–87, 2001.

Moret

Pierot

: Endovascular treatment of anterior communicating artery aneurysms using Guglielmi detachable coils. Neuroradiology 38: 800–805, 1996.

Perlmutter

Rhoton

Jr : Microsurgical anatomy of the anterior cerebral-anterior communicating recurrent artery complex. J Neurosurg 45: 259–272, 1976.

Proust

Debono

: Treatment of anterior communicating artery aneurysms: Complementary aspects of microsurgical and endovascular procedures. J Neurosurg 99: 3–14, 2003.

Sonobe

Nakai

: Treatment for ruptured cerebral aneurysm in acute stage: GDC embolization as the first choice treatment. Surgery for Cerebral Stroke (Japan) 32: 271–274, 2004.

Viñuela

Duckwiler

Mawad

: Guglielmi detachable coil embolization of acute intracranial aneurysm: Perioperative anatomical and clinical outcome in 403 patients. J Neurosurg 86: 475–482, 1997.

Yasargil

: Microneurosurgery: In 4 Volumes. New York, Thieme, Vol. II, 165–184, 1984.