Management of Anterior Choroidal Artery Aneurysms: A Retrospective Cohort Study
<b>Background:</b> Anterior choroidal artery (AChoA) aneurysms pose a challenge for both endovascular and clipping procedures. The eloquent territory supplied by the parent vessel has limited collateralization and its compromise can lead to significant morbidity. This study aims to analy...
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2024-12-01
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| author | Andrew Falzon Shigeta Miyake Tze Phei Kee Hugo Andrade-Barazarte Timo Krings |
| author_facet | Andrew Falzon Shigeta Miyake Tze Phei Kee Hugo Andrade-Barazarte Timo Krings |
| author_sort | Andrew Falzon |
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| description | <b>Background:</b> Anterior choroidal artery (AChoA) aneurysms pose a challenge for both endovascular and clipping procedures. The eloquent territory supplied by the parent vessel has limited collateralization and its compromise can lead to significant morbidity. This study aims to analyze the clinical outcomes and procedure-related complications of clipping and endovascular treatment of AChoA aneurysms to aid physician decision making. <b>Methods:</b> Thirty-two ruptured and unruptured AChoA aneurysms that underwent catheter angiography at a single neurovascular center between January 2000 and December 2023 were included. Either conservative management, clipping, and/or endovascular treatment were performed. Clinical outcomes and complications were analyzed retrospectively. <b>Results:</b> Twenty-four endovascular treatments and seven clipping procedures were included. Of the total 24 endovascular procedures, 46% were primary coiling, 25% were balloon-assisted coiling, 13% were flow diverting stent, 8% were combined balloon-assisted coiling and flow diverting stent, and 8% were combined balloon-assisted and stent-assisted coiling. There was no procedure-related mortality in both groups. No intra- or post-procedural ruptures/re-ruptures occurred during follow-up in both endovascular and clipping cohorts. AChoA territory infarcts occurred in 4% of the endovascular and 29% of the clipping cohorts. Other thromboembolic complications occurred in 4% of the endovascular cohort. The recurrence rate requiring retreatment was 12.5% for the endovascular and 43% for the clipping cohort. A favorable clinical outcome (mRS ≤ 2) was 78% for the endovascular cohort and 67% for the clipping cohort. <b>Conclusions:</b> Endovascular and clipping outcomes align with prior studies, with endovascular showing a favorable safety profile. Both approaches are viable, though they present distinct risks and advantages. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Brain Sciences |
| spelling | doaj-art-a595efec04874af5b52178beb317ce0f2025-01-24T13:25:38ZengMDPI AGBrain Sciences2076-34252024-12-01151510.3390/brainsci15010005Management of Anterior Choroidal Artery Aneurysms: A Retrospective Cohort StudyAndrew Falzon0Shigeta Miyake1Tze Phei Kee2Hugo Andrade-Barazarte3Timo Krings4Department of Neuroradiology, Atkinson Morley Regional Neuroscience Centre, St George’s University Hospital, Tooting, London SW17 0QT, UKDepartment of Neurosurgery, Yokohama City University School of Medicine, Yokohama 236-004, JapanDepartment of Neuroradiology, National Neuroscience Institute, Singapore 308433, SingaporeDivision of Neurosurgery, Toronto Western Hospital, Toronto, ON M5T 2S8, CanadaDivision of Neurointerventional Radiology, UMass-Chan Lahey Department of Radiology, Lahey Hospital and Medical Centre—Beth Israel Lahey Health, Burlington, MA 01805, USA<b>Background:</b> Anterior choroidal artery (AChoA) aneurysms pose a challenge for both endovascular and clipping procedures. The eloquent territory supplied by the parent vessel has limited collateralization and its compromise can lead to significant morbidity. This study aims to analyze the clinical outcomes and procedure-related complications of clipping and endovascular treatment of AChoA aneurysms to aid physician decision making. <b>Methods:</b> Thirty-two ruptured and unruptured AChoA aneurysms that underwent catheter angiography at a single neurovascular center between January 2000 and December 2023 were included. Either conservative management, clipping, and/or endovascular treatment were performed. Clinical outcomes and complications were analyzed retrospectively. <b>Results:</b> Twenty-four endovascular treatments and seven clipping procedures were included. Of the total 24 endovascular procedures, 46% were primary coiling, 25% were balloon-assisted coiling, 13% were flow diverting stent, 8% were combined balloon-assisted coiling and flow diverting stent, and 8% were combined balloon-assisted and stent-assisted coiling. There was no procedure-related mortality in both groups. No intra- or post-procedural ruptures/re-ruptures occurred during follow-up in both endovascular and clipping cohorts. AChoA territory infarcts occurred in 4% of the endovascular and 29% of the clipping cohorts. Other thromboembolic complications occurred in 4% of the endovascular cohort. The recurrence rate requiring retreatment was 12.5% for the endovascular and 43% for the clipping cohort. A favorable clinical outcome (mRS ≤ 2) was 78% for the endovascular cohort and 67% for the clipping cohort. <b>Conclusions:</b> Endovascular and clipping outcomes align with prior studies, with endovascular showing a favorable safety profile. Both approaches are viable, though they present distinct risks and advantages.https://www.mdpi.com/2076-3425/15/1/5anterior choroidal artery aneurysmendovascularflow diverter stentballoon-assisted coilingstent-assisted coilingclipping |
| spellingShingle | Andrew Falzon Shigeta Miyake Tze Phei Kee Hugo Andrade-Barazarte Timo Krings Management of Anterior Choroidal Artery Aneurysms: A Retrospective Cohort Study Brain Sciences anterior choroidal artery aneurysm endovascular flow diverter stent balloon-assisted coiling stent-assisted coiling clipping |
| title | Management of Anterior Choroidal Artery Aneurysms: A Retrospective Cohort Study |
| title_full | Management of Anterior Choroidal Artery Aneurysms: A Retrospective Cohort Study |
| title_fullStr | Management of Anterior Choroidal Artery Aneurysms: A Retrospective Cohort Study |
| title_full_unstemmed | Management of Anterior Choroidal Artery Aneurysms: A Retrospective Cohort Study |
| title_short | Management of Anterior Choroidal Artery Aneurysms: A Retrospective Cohort Study |
| title_sort | management of anterior choroidal artery aneurysms a retrospective cohort study |
| topic | anterior choroidal artery aneurysm endovascular flow diverter stent balloon-assisted coiling stent-assisted coiling clipping |
| url | https://www.mdpi.com/2076-3425/15/1/5 |
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