Abstract
SUMMARY: The goal of this study was to evaluate the feasibility and efficacy of A1 occlusion at the level of wide necked A1 aneurysms, where there are bilateral patent A1 segments and a patent AcomA. Between 2000 and 2010, 9 patients with wide necked A1 aneurysms were treated by coiling of the aneurysm along with parent vessel occlusion. All aneurysms had a wide neck (≥4mm). None were treated in the acute phase of a subarachnoid hemorrhage. Three small infarcts were noted on routine post-treatment head CT, 1 of which was symptomatic (transient hemiparesthesia). On control angiogram at 6 months or more, 3 A1 recanalizations were found, 2 of which had a stable small neck recurrence. None of the aneurysms ruptured on follow-up. In this series, parent artery occlusion was effective in treating wide-necked aneurysms arising from the A1 segment in patients with adequate collateral supply.
Abbreviations
- A1
- the first segment of the ACA up to the AcomA
- A2
- the second segment of the ACA from the AcomA to the genu of the corpus callosum
- ACA
- anterior cerebral artery
- AcomA
- anterior communicating artery
- c
- coiling
- Dist
- distal third of the A1
- DSA
- digital subtraction angiography
- EVT
- endovascular treatment
- FU
- follow-up
- L
- left
- MD
- maximum diameter
- Mid
- middle third of the A1
- MRA
- MR angiography
- N
- neck
- OD
- oculi dexter (right eye)
- Prox
- proximal third of the A1
- R
- right
- RAH
- recurrent artery of Heubner
- s
- surgery
- SAH
- subarachnoid hemorrhage
- Copyright © American Society of Neuroradiology