Patency of the Anterior Choroidal Artery after Flow-Diversion Treatment of Internal Carotid Artery Aneurysms

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Figure.
Occlusion of anterior choroidal artery on follow-up angiography. A, Anteroposterior view of the anterior choroidal artery on pretreatment angiography demonstrates a patent anterior choroidal artery (black arrows). B, Follow-up angiogram 7 months posttreatment demonstrates absence of filling of the anterior choroidal artery. C, Lateral view of the anterior choroidal artery on pretreatment angiography demonstrates that it is patent (black arrows). D, Follow-up angiogram 7 months posttreatment demonstrates absence of filling of the anterior choroidal artery.

Table 1:

Patient characteristics

Patient No.	Presentation	Side	Aneurysm Location	Prior Coiling	Aneurysm Size (mm)
1	VF deficit	Left	Carotid terminus	Yes	25
2	Headache	Left	PcomA	No	27
3	SAH	Left	ICA blister	No	4
4	Asymptomatic	Right	PcomA	No	3
5	Prior SAH	Left	Paraclinoid	Yes	13
6	Headache	Left	PcomA	Yes	16
7	Prior SAH	Left	Carotid terminus	Yes	20
8	Asymptomatic	Left	PcomA	No	7
9	Asymptomatic	Left	AchoA	No	11
10	Symptomatic	Left	PcomA	No	20
11	Prior SAH	Right	PcomA	Yes	10
12	Asymptomatic	Left	PcomA	No	11
13	Asymptomatic	Left	Paraclinoid	No	13
14	Prior SAH	Left	Paraclinoid	Yes	16
15	Asymptomatic	Right	PcomA	No	4

Table 2:

Angiographic results

Patient No.	No. of Devices	Immediate Postangiography AchoA Patency	Long-Term Patency	Angiographic Follow-Up (mo)	Aneurysm Occlusion, Last Follow-Up
1	3	Patent	Patent	14	Occluded
2	2	Patent	Patent	30	Residual aneurysm
3	1	Patent	NA	1 day	NA
4	2	Patent	Patent	25	Residual aneurysm
5	1	Patent	Patient	13	Residual neck
6	1	Patent	Patent	6	Residual neck
7	1	Patent	Patent	9	Occluded
8	1	Patent	Patent	12	Residual aneurysm
9	1	Patent	Patent	12	Residual aneurysm
10	2	Patent	Patent	12	Residual aneurysm
11	1	Patent	Patent	6	Occluded
12	1	Patent	Patent	6	Occluded
13	1	Patent	Patent	12	Occluded
14	1	Patent	Patent	6	Occluded
15	1	Patent	Occluded	7	Occluded

Table 3:

Clinical and MRI/CT Results

Patient No.	mRS at Last Follow-Up	Reason for mRS	Clinical Follow-Up Time (mo)	Follow-Up MRI/CT Findings at <1 Month	Follow-Up Imaging Findings at >1 Month
1	2	Headaches	27	MRI: tiny silent infarcts, none in AchoA territory	MRI: no new infarcts
2	1	Abdominal pain	30	NA	CT: tiny infarcts, none in AchoA territory
3	6	Death	0.3	CT: watershed infarcts, intraparenchymal hemorrhage
4	0	–	25	NA	NA
5	2	CN IV paresis, double vision	13	MRI: tiny silent infarcts, none in AchoA territory	CT: no new infarcts
6	0	–	6	MRI: tiny silent infarcts, none in AchoA territory	MRI: no new infarcts
7	1	Shoulder pain	9	MRI: tiny silent infarcts, none in AchoA territory	MRI: no new infarcts
8	0		12	NA	NA
9	1	Headaches	12	NA	NA
10	1	Headaches	12	MRI: tiny silent infarcts, none in AchoA territory	MRI: no new infarcts
11	0	–	6	NA	NA
12	0	–	6	NA	NA
13	0	–	12	NA	CT: no new infarcts
14	0	–	6	MRI: tiny silent infarcts, none in AchoA territory	NA
15	0	–	7	MRI: tiny silent infarcts, none in AchoA territory	MRI: no new infarcts