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Complication Risk Factors in Anterior Choroidal Artery Aneurysm Treatment

Clinical Neuroradiology volume 28, pages 345–356 (2018)Cite this article

Abstract

Object

The anterior choroidal artery (AChoA) is a rare location for intracranial aneurysms. The treatment of these aneurysms may be challenging due to the risk of occlusion of such a small and eloquent artery as the AChoA. We aimed to evaluate the risk factors for complications in AChoA aneurysm treatment.

Methods

We retrospectively analyzed 47 consecutive AChoA aneurysms in 40 patients treated in our institution from 1999 and 2014 by endovascular means (87%) or surgical clipping (13%). Minor (transient or minor neurological deficits) and major complications (severe permanent neurological deficits or death) were systematically recorded. The influence of patient age, sex, aneurysm size, neck size, shape, dome-to-neck ratio and treatment technique on the occurrence of procedure-related complications was evaluated.

Results

Of the patients 11 experienced procedure-related complications (5 major, 6 minor). Aneurysms with multilobed shape were significantly associated with a higher procedure-related complication rate. There was a tendency for higher major procedure-related complication rate in small volume aneurysms. We did not find any association between the other factors analyzed and occurrence of procedure-related complications.

Conclusion

Treatment of AChoA aneurysms has an acceptable complication risk. We did not find any significant differences between surgical and endovascular treatment in terms of procedure-related complication rates. Multilobed aneurysms were significantly associated with a higher procedure-related complication rate.

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Abbreviations

ACA:

Anterior cerebral artery

AChoA:

Anterior choroidal artery

CT:

Computed tomography

DSA:

Digital subtraction angiography

ICA:

Internal carotid artery

MRI:

Magnetic resonance imaging

mRS:

Modified Rankin scale

PCom:

Posterior communicating artery

SAH:

Subarachnoid hemorrhage

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Authors and Affiliations

  1. Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Assistance-Publique Hôpitaux de Paris, 47 boulevard de l’hôpital, 75013, Paris, France

    Arthur André, Anne-Laure Boch, Aurélien Nouet, Stéphane Clémenceau & Philippe Cornu

  2. Department of Interventional Neuroradiology, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France

    Federico Di Maria, Nader Sourour, Joseph Gabrieli, Jacques Chiras & Frédéric Clarençon

  3. Department of Anesthesiology, Pitié-Salpêtrière University Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France

    Vincent Degos & Chiheb Zeghal

  4. Pierre et Marie Curie University, Sorbonne Universités, Paris, France

    Arthur André, Vincent Degos, Jacques Chiras, Philippe Cornu & Frédéric Clarençon

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  1. Arthur André
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Corresponding author

Correspondence to Arthur André.

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Conflict of interest

A. André, A.-L. Boch, F. Di Maria, A. Nouet, N. Sourour, S. Clémenceau, J. Gabrieli, V. Degos, C. Zeghal, J. Chiras, P. Cornu and F. Clarençon declare that they have no competing interests.

Ethical standards

Neither approval of the institutional review board nor patient informed consent are required by the ethics committee of our institution for retrospective analyses of patient records and imaging data.

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Contributions

A. André: Project development, Data Collection, Manuscript writing; A.L. Boch: Data collection, procedures; F. Di Maria: Data collection, procedures; A. Nouet: Data collection, procedures; N. Sourour: Data collection, procedures; S. Clemenceau: Data collection, procedures; J. Gabrieli: Data collection, procedures; V. Degos: Data collection, procedures; C. Zeghal: Data collection, procedures; J. Chiras: Data collection, procedures; P. Cornu: Data collection, procedures; F. Clarençon: Project development, Data collection, Manuscript writing

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André, A., Boch, AL., Di Maria, F. et al. Complication Risk Factors in Anterior Choroidal Artery Aneurysm Treatment. Clin Neuroradiol 28, 345–356 (2018). https://doi.org/10.1007/s00062-017-0575-y

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  • DOI: https://doi.org/10.1007/s00062-017-0575-y

Keywords

  • Intracranial aneurysm
  • Anterior choroidal artery
  • Endovascular treatment
  • Clipping
  • Ischemia