Safety and efficacy of different therapeutic strategies in the endovascular treatment of anterior cerebral artery aneurysms with different features: A single centre experience

Clin Neurol Neurosurg. 2020 Jun:193:105786. doi: 10.1016/j.clineuro.2020.105786. Epub 2020 Mar 16.

Abstract

Background: Outcomes of endovascular treatment of anterior cerebral artery (ACA) aneurysms are still not well-characterized.

Objective: The study aimed to review the clinical effect, procedure-related complications and follow-up outcomes and to evaluate the safety and efficacy of endovascular treatment of ACA aneurysms in our center experience.

Methods: From August 2014 to August 2018, a total of 75 consecutive patients with 77 ACA aneurysms were treated via the endovascular approach after providing informed consent. A retrospective review of the clinical, radiological, and endovascular details of these patients was conducted.

Results: The mortality and the morbidity in this study were 4% and 9.3%, respectively. Compared with A1 and A2 aneurysms, intraoperative rupture was more common in A3 aneurysms (P = 0.029). Difference between the ruptured and unruptured aneurysms in the distribution of therapeutic strategy (P = 0.003) and immediate embolization degree (P = 0.004) was also significant. Statistical analysis demonstrated that the larger aneurysm (P = 0.031) was, the greater the ratio of aneurysm size to parent artery diameter (P = 0.029) was, the more likely the unruptured aneurysms were to occur ischemic events. Higher Hunt-Hess grade (P = 0.0066) was an independent risk factor for poor clinical outcome.

Conclusion: Endovascular treatment is feasible and effective for ACA aneurysms.

Keywords: Anterior cerebral artery; Cerebral aneurysms; Endovascular treatment.

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured / diagnostic imaging
  • Aneurysm, Ruptured / mortality
  • Aneurysm, Ruptured / surgery
  • Angiography, Digital Subtraction
  • Anterior Cerebral Artery / surgery*
  • Brain Ischemia / epidemiology
  • Brain Ischemia / etiology
  • Embolization, Therapeutic
  • Endovascular Procedures / adverse effects*
  • Endovascular Procedures / methods*
  • Endovascular Procedures / mortality
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / mortality
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Neurosurgical Procedures / methods*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / epidemiology
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome