Technical strategy in endovascular treatment of proximal anterior cerebral artery aneurysms

Acta Neurochir (Wien). 2011 Feb;153(2):279-85. doi: 10.1007/s00701-010-0804-5. Epub 2010 Sep 26.


Purpose: There have been few reports on the endovascular treatment of aneurysms arising from A1 due to their rarity. We report the angiographic results, clinical outcomes, and technical aspects of endovascular treatment for 13 A1 aneurysms in 12 patients.

Methods: From January 2002 to November 2007, 12 patients (9 females and 3 males) with 13 A1 aneurysms underwent endovascular treatment. Three of these patients presented with subarachnoid hemorrhage, and 10 unruptured aneurysms were detected in 9 patients. All of the aneurysms were successfully treated with coil embolization. Most of the aneurysms projected posteriorly (61.5%) and were located in the proximal A1 segment (69.2%). Procedural, clinical, and radiological follow-up data were reviewed.

Results: Procedure-related complications occurred in 3 patients (25%) and included 1 non-leaking aneurysmal perforation and 2 thromboembolic events; none of them were clinically significant. No bleeding or rebleeding occurred during the follow-up period in this cohort of patients.

Conclusions: Endovascular coil embolization is an effective treatment modality for A1 aneurysms. Tailored microcatheter shaping according to aneurysm projection and location is necessary. Long-term follow-up studies involving a larger number of patients and further comparisons with surgical data are needed.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods*
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods*
  • Endovascular Procedures / trends
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / pathology*
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods*
  • Radiography
  • Retrospective Studies
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / pathology*
  • Subarachnoid Hemorrhage / therapy*
  • Young Adult