Endovascular treatment of anterior choroidal artery aneurysms

Senturk, Cagin; Bandeira, Alexandra; Bruneau, Michaël; Dewindt, A; Balériaux, Danielle; Witte, Olivier De; Lubicz, Boris

doi:10.1016/j.neurad.2008.12.002

Cited by 13 publications

(8 citation statements)

References 10 publications

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“…In the current and six other series that reported on the origin of the AChA in association with the aneurysm (Table 2, 3), a total of 172 (45.5%) out of 378 aneurysms had the AChA arising from the aneurysm base rather than the junction of the ICA and the aneurysm1,8,9,11,15,16).…”

Section: Discussionmentioning

confidence: 58%

“…The incidence of permanent AChA syndrome after surgical clipping of an AChA aneurysm has consistently been reported to range from 5.3% to 15.7%1,5,6,10,11,17,20). When compared with surgical series, endovascular series have a much lower incidence of AChA insufficiency, although only a few series have been reported8-10,15,16). However, the favorable surgical outcomes of the current series, no occurrence of permanent AChA syndrome in the 62 patients, would seem to suggest that the risk of AChA insufficiency can be reduced with appropriate surgical techniques and intraoperative monitoring18).…”

Section: Discussionmentioning

confidence: 73%

“…Regarding the endovascular coiling of AChA aneurysms, the previous reports show that endovascular treatment is effective for preventing aneurysmal ruptures and recurrent bleeding with low morbidity and mortality rates8-10,15,16). However, there are significant concerns with an endovascular procedure, including thrombotic occlusion of the AChA, a fatal procedural aneurysm rupture, and high recurrence rate of occluded aneurysms over a long-term period8-10,14-16).…”

Section: Discussionmentioning

confidence: 99%

“…However, there are significant concerns with an endovascular procedure, including thrombotic occlusion of the AChA, a fatal procedural aneurysm rupture, and high recurrence rate of occluded aneurysms over a long-term period8-10,14-16).…”

Section: Discussionmentioning

confidence: 99%

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Anterior Choroidal Artery Aneurysm Surgery: Ischemic Complications and Clinical Outcomes Revisited

Lee

Park

2013

J Korean Neurosurg Soc

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ObjectiveSurgical results for anterior choroidal artery (AChA) aneurysms have previously been reported as unsatisfactory due to inadvertent occlusion of the AChA, while the low incidence of AChA aneurysms hampers the accumulation of surgical experience. The authors reviewed their related surgical experience to document the ischemic complications and surgical outcomes.MethodsIdentification of the AChA at its origin by rigorous visual scrutiny, careful microdissection, and meticulous clip placement to avoid the AChA origin are all crucial surgical maneuvers. A retrospective review of a surgical series of 62 consecutive cases of an AChA aneurysm between 2004 and 2012 was performed.ResultsAll patients, except for five (8.1%) with a small residual neck, showed complete aneurysm obliteration in postoperative angiographic evaluations. There was no incidence of procedure-related permanent AChA syndrome or oculomotor nerve palsy, while three (4.8%) patients suffered from transient AChA syndrome. The clinical outcomes [the 3-month modified Rankin Scale (mRS)] of the patients were related to their preoperative World Federation of Neurologic Surgeons (WFNS) grade. As regards the 3-month mRS, significant differences were found between patients with an unruptured aneurysm (WFNS grade 0; n=20), good-grade subarachnoid hemorrhage (WFNS grade 1-3; n=30), and poor-grade subarachnoid hemorrhage (WFNS grade 4-5; n=4).ConclusionIn surgical treatment of AChA aneurysms, a risk of AChA insufficiency can be minimized by taking every precaution to preserve the AChA patency and intraoperative monitoring. In addition, the surgical outcome is primarily determined by the preoperative clinical state.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Anterior Choroidal Artery Aneurysm Surgery: Ischemic Complications and Clinical Outcomes Revisited

Lee

Park

2013

J Korean Neurosurg Soc

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“…In distal AChA aneurysms, if the treatment requires AChA occlusion, preoperative provocative testing should be considered 31 . Although surgery is considered the traditional treatment for distal AChA aneurysms, the potential use of endovascular techniques has recently gained increasing attention 27 , 32 , 33 .…”

Section: Aneurysmmentioning

confidence: 99%

Clinical importance of the anterior choroidal artery: a review of the literature

Xu¹,

Zhao²,

Yu³

2018

Int. J. Med. Sci.

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The anterior choroidal artery (AChA) is a critical artery in brain physiology and function. The AChA is involved in many diseases, including aneurysm, brain infarct, Moyamoya disease (MMD), brain tumor, arteriovenous malformation (AVM), etc. The AChA is vulnerable to damage during the treatment of these diseases and is thus a very important vessel. However, a comprehensive systematic review of the importance of the AChA is currently lacking. In this study, we used the PUBMED database to perform a literature review of the AChA to increase our understanding of its role in neurophysiology. Although the AChA is a small thin artery, it supplies an extremely important region of the brain. The AChA consists of cisternal and plexal segments, and the point of entry into the choroidal plexus is known as the plexal point. During treatment for aneurysms, tumors, AVM or AVF, the AChA cisternal segments should be preserved as a pathway to prevent the infarction of the AChA target region in the brain. In MMD, a dilated AChA provides collateral flow for posterior circulation. In brain infarcts, rapid treatment is necessary to prevent brain damage. In Parkinson disease (PD), the role of the AChA is unclear. In trauma, the AChA can tear and result in intracranial hematoma. In addition, both chronic and non-chronic branch vessel occlusions in the AChA are clinically silent and should not deter aneurysm treatment with flow diversion. Based on the data available, the AChA is a highly essential vessel.

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