scholarly journals Safety and Efficacy of Endovascular Treatment for Ruptured Small Anterior Communicating Artery Aneurysms by Selecting an Appropriate Supporting Point and Microcatheter Tip Shaping Determined by the Course of the Blood Vessel

2019 ◽  
Vol 4 (1) ◽  
pp. 14-19
Author(s):  
Takao Hashimoto ◽  
Tomoo Ohashi ◽  
Daisuke Watanabe ◽  
Hiroaki Namatame ◽  
Hirofumi Okada ◽  
...  
Keyword(s):  
Blood Vessel ◽  
Endovascular Treatment ◽  
Anterior Communicating Artery ◽  
Safety And Efficacy ◽  
Supporting Point ◽  
Anterior Communicating Artery Aneurysms

scholarly journals Endovascular Treatment of ACom Intracranial Aneurysms

2010 ◽  
Vol 16 (1) ◽  
pp. 7-16 ◽  
Author(s):  
S. Finitsis ◽  
R. Anxionnat ◽  
A. Lebedinsky ◽  
P.C. Albuquerque ◽  
M.F. Clayton ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Additional Treatment ◽  
Anterior Communicating Artery ◽  
Anticoagulation Management ◽  
Unruptured Aneurysms ◽  
Anterior Communicating Artery Aneurysms ◽  
Group 2 ◽  
Group 1

The immediate and long-term outcomes, complications, recurrences and the need for retreatment were analyzed in a series of 280 consecutive patients with anterior communicating artery aneurysms treated with the endovascular technique. From October 1992 to October 2001 280 patients with 282 anterior communicating artery aneurysms were addressed to our center. For the analysis, the population was divided into two major groups: group 1, comprising 239 (85%) patients with ruptured aneurysms and group 2 comprising of 42 (15%) patients with unruptured aneurysms. In group 1, 185 (77.4%) patients had a good initial pre-treatment Hunt and Hess grade of I-III. Aneurysm size was divided into three categories according to the larger diameter: less than 4 mm, between 4 and 10 mm and larger than 10 mm. The sizes of aneurysms in groups 1 and 2 were identical but a less favorable neck to depth ratio of 0.5 was more frequent in group 2. Endovascular treatment was finally performed in 234 patients in group 1 and 34 patients in group 2. Complete obliteration was more frequently obtained in group 2 unlike a residual neck or opacification of the sac that were more frequently seen in group 1. No peri-treatment complications were recorded in group 2. In group 1 the peri-treatment mortality and overall peri-treatment morbidity were 5.1% and 8.1% respectively. Eight patients (3.4%) in group 1 presented early post treatment rebleeding with a mortality of 88%. The mean time to follow-up was 3.09 years. In group 1, 51 (21.7%) recurrences occurred of which 14 were minor and 37 major. In group 2, eight (23.5%) recurrences occurred, five minor and three major. Two patients (0.8%) presented late rebleeding in group 1. Twenty-seven second endovascular retreatments were performed, 24 (10.2%) in group 1 and three (8.8%) in group 2, seven third endovascular retreatments and two surgical clippings in group 1 only. There was no additional morbidity related to retreatments. Endovascular treatment is an effective method for the treatment of anterior communicating artery aneurysms allowing late rebleeding prevention. Peri-treatment rebleeding warrants caution in anticoagulation management. This is a single center experience and the follow-up period is limited. Patients should be followed-up in the long-term as recurrences may occur and warrant additional treatment.

scholarly journals Endovascular Treatment of Anterior Communicating Artery Aneurysms: A Systematic Review and Meta-Analysis

2013 ◽  
Vol 35 (5) ◽  
pp. 943-947 ◽  
Author(s):  
S. Fang ◽  
W. Brinjikji ◽  
M. H. Murad ◽  
D. F. Kallmes ◽  
H. J. Cloft ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endovascular Treatment ◽  
Meta Analysis ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysms

HyperForm balloon remodeling in the endovascular treatment of anterior cerebral, middle cerebral, and anterior communicating artery aneurysms: clinical and angiographic follow-up results in 800 consecutive patients

2011 ◽  
Vol 114 (4) ◽  
pp. 944-953 ◽  
Author(s):  
H. Saruhan Cekirge ◽  
Kivilcim Yavuz ◽  
Serdar Geyik ◽  
Isil Saatci
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Coil Embolization ◽  
Neurological Deficits ◽  
Anterior Communicating Artery ◽  
Severe Bleeding ◽  
Negative Consequences ◽  
Anterior Circulation ◽  
Anterior Communicating Artery Aneurysms

Object The purpose of this paper was to present the safety, efficacy, and clinical/angiographic follow-up results of HyperForm balloon-assisted endosaccular coil occlusion of distal anterior circulation bifurcation aneurysms. Methods Over a 7-year period, the authors treated 864 middle cerebral artery, distal anterior cerebral artery bifurcation, and anterior communicating artery aneurysms by means of coil embolization with HyperForm balloon assistance in 800 patients. In 37 aneurysms, 2 HyperForm balloons were used simultaneously for remodeling. Results The overall mortality rate was 7.1%, including 1.4% procedural mortality. Various neurological deficits were present at discharge in 8.9% of the patients, and 4.4% had permanent disabling morbidity 6 months posttreatment (modified Rankin Scale score ≥ 2). Thromboembolic complications developed during the treatment of 15 aneurysms (1.7%) causing morbidity or mortality in 10 cases (1.3%). There were 14 intraoperative perforations (1.6%). In all 14 cases, the HyperForm balloon saved patients from severe bleeding. The perforation led to morbidity or mortality in 3 cases (0.4%); there were no negative consequences in 11. There were 726 patients with 757 aneurysms (87.6%) available for follow-up. Control angiograms were obtained at 6 months in 386 patients, at 1 year in 267, and at 2 years in 104, revealing an 82% complete obliteration rate according to the most recent follow-up angiograms. Conclusions The satisfactory results obtained in this experience demonstrate that HyperForm balloon remodeling provides strong benefits for the endovascular management of middle cerebral, anterior cerebral, and anterior communicating artery aneurysms without increasing the risk of treatment. Not only does this technique allow for the safe treatment of these aneurysms, but it also expands the indications of endovascular treatment to include aneurysms that otherwise cannot be treated with simple coil embolization.

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