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anterior_communicating_artery_aneurysm_treatment

Anterior communicating artery aneurysm treatment

The aspect ratio, direction of the dome, and fenestration should be examined most meticulously when deciding when to treat an Anterior communicating artery aneurysm 1).

The direction in which the fundus projects was chosen as the morphological criterion between endovascular and surgical methods. Proust et al. proposed that microsurgical clip application should be the preferred option in the treatment of ACoA aneurysms with anteriorly directed fundi and that endovascular packing be selected for those lesions with posteriorly directed fundi, depending on morphological criteria 2).

Endovascular coiling (EC) resulted in a more favorable clinical outcome, and microsurgical clipping (MC) resulted in more robust aneurysm repair, for unruptured ACoA aneurysms. Stent assisted coiling (SAC) had a higher treatment morbidity risk than EC, without reduction in retreatment rate. All treatments were effective in preventing SAH. The current pooled analysis of treatment outcomes provides a useful aid to pretreatment clinical decision making 3).


Morphological Scoring System of Choi 4).

Endovascular treatment

Surgery

References

1)
Cai W, Hu C, Gong J, Lan Q. Anterior Communicating Artery Aneurysm Morphology and the Risk of Rupture. World Neurosurg. 2018 Jan;109:119-126. doi: 10.1016/j.wneu.2017.09.118. Epub 2017 Sep 27. Review. PubMed PMID: 28958928.
2)
Proust F, Debono B, Hannequin D, Gerardin E, Clavier E, Langlois O, Fréger P. Treatment of anterior communicating artery aneurysms: complementary aspects of microsurgical and endovascular procedures. J Neurosurg. 2003 Jul;99(1):3-14. PubMed PMID: 12854737.
3)
O'Neill AH, Chandra RV, Lai LT. Safety and effectiveness of microsurgical clipping, endovascular coiling, and stent assisted coiling for unruptured anterior communicating artery aneurysms: a systematic analysis of observational studies. J Neurointerv Surg. 2016 Sep 13. pii: neurintsurg-2016-012629. doi: 10.1136/neurintsurg-2016-012629. [Epub ahead of print] Review. PubMed PMID: 27624158.
4)
Choi JH, Kang MJ, Huh JT. Influence of clinical and anatomic features on treatment decisions for anterior communicating artery aneurysms. J Korean Neurosurg Soc. 2011 Aug;50(2):81-8. doi: 10.3340/jkns.2011.50.2.81. Epub 2011 Aug 31. PubMed PMID: 22053224; PubMed Central PMCID: PMC3206283.
anterior_communicating_artery_aneurysm_treatment.txt · Last modified: 2019/10/28 18:32 by administrador