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Endovascular treatment of proximal anterior cerebral artery aneurysms

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Aneurysms of the proximal segment of the anterior cerebral artery (A1A) are rare and challenging to treat. No information is available regarding their management by endovascular approach. The aim of this study was to report our experience with endovascular treatment (EVT) of A1As.

Patients and methods

A retrospective review of our prospectively maintained database identified all A1As treated in our institution. The clinical charts, procedural data, and angiographic results were reviewed.

Results

From April 2004 to August 2008, eight patients were identified and presented with an unruptured A1A. All aneurysms but one were <3 mm in diameter and two aneurysms had a perforator at the neck. Surgery was performed in two patients with an aneurysm <2 mm. Six patients were treated by selective embolization including five patients with balloon-assisted coiling (BAC) and/or via a retrograde approach from the contralateral side through the anterior communicating artery. These adjunctive techniques were used to safely catheterize the sac or to protect a branch at the neck. All patients showed an excellent clinical outcome. A complete aneurysm occlusion was obtained in all but one patient. Follow-up imaging in four patients showed stable results.

Conclusion

EVT of A1As is feasible and associated with good clinical and anatomical results. Because of their location, small size, and close relationship with perforators, EVT frequently requires the use of BAC and/or a retrograde approach. Our results suggest that EVT is an alternative therapeutic option to surgical clipping if the aneurysm size is compatible with selective embolization.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neuroradiology, Erasme University Hospital, Brussels, Belgium

    Boris Lubicz & Danielle Balériaux

  2. Department of Neurology, Erasme University Hospital, Brussels, Belgium

    Aloys Dewindt

  3. Department of Neurosurgery, Erasme University Hospital, Brussels, Belgium

    Michaël Bruneau, Florence Lefranc & Olivier De Witte

  4. Service de Radiologie, Hôpital Erasme, 808 route de Lennik, 1070, Brussels, Belgium

    Boris Lubicz

Authors
  1. Boris Lubicz
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  2. Michaël Bruneau
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  3. Aloys Dewindt
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  4. Florence Lefranc
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  5. Danielle Balériaux
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  6. Olivier De Witte
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Correspondence to Boris Lubicz.

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Lubicz, B., Bruneau, M., Dewindt, A. et al. Endovascular treatment of proximal anterior cerebral artery aneurysms. Neuroradiology 51, 99–102 (2009). https://doi.org/10.1007/s00234-008-0474-7

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  • DOI: https://doi.org/10.1007/s00234-008-0474-7

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