1 research outputs found
Outcomes of endovascular coiling of anterior communicating artery aneurysms in the early post-rupture period: A prospective analysis
Background : There have been significant advances in the technical
aspects of endovascular therapy of cerebral aneurysms. Anterior
communicating artery (Acom A) aneurysms were traditionally treated by
surgical clipping. Endovascular coiling has the distinct advantage of
being minimally invasive and can be performed anytime during the course
of subarachnoid hemorrhage (SAH). Aims : To evaluate the results of
endovascular coiling of Acom A aneurysms in the early post-rupture
period. Material and Methods : Between June 1999 and December 2009,
103 Acom A aneurysms were treated with endovascular coiling. All the
patients underwent digital subtraction angiography (DSA) and a
diagnostic 3D rotational angiogram (3D-RA), followed by coiling using
dedicated intracranial coils. Results : Of the 103 patients coiled,
52% presented in Fischer grade 3/4 SAH and 13.5% in Hunt and Hess grade
4/5. Technical success was 98%. Complete obliteration of the aneurysm
was achieved in 97 (94%) patients. Only one patient died of direct
procedure-related complication due to coil prolapse. None of the
patients had rebleeds. Six-month check angiogram performed in 34
patients showed significant recanalization in one patient. Conclusion
: Ruptured Acom A aneurysms are implicated in majority of cases of SAH.
Our results support the latest guideline "that endovascular coil
occlusion of the aneurysm is appropriate for patients with a ruptured
cerebral artery aneurysm that is deemed treatable either by
endovascular coiling or by surgical clipping.