Endovascular treatment of aneurysms of proximal segments (A1) of anterior cerebral arteries

WU De-gang; LI Zhen-bao; ZHAO Xin-tong; YUAN Jin-long; QIN Fei-yun; SHEN Bin; ZHANG Bing-bing; FANG Xin-gen

doi:10.13792017.09/j.issn.1009-153X.2017.10.003

Abstract：Objective To explore the methods to treat the aneurysms of the proximal segment (A1) of the anterior cerebral arteries (ACA) by endovascular embolization and its effects. Methods The clinical data of 25 patients with ACA A1 segment aneurysms, who underwent endovascular embolization from April, 2013 to February, 2017, were analyzed retrospectively. The curative effects were evaluated by Raymond grading immediately after the embolization. The intraoperative and postoperative complications were observed and 16 patients were followed up by clinical and imaging methods from 3 to 24 months after the operation. Results Of 25 patients, 15 were treated by pure coils embolization, 5 by stent-assisted coils embolization, 3 by the occlusion of the parent arteries with coils, 1 by stent implantation and 1 by balloon-assisted embolization. The outcomes were Raymond gradeⅠin 19 patients, gradeⅡin 5 and gradeⅢ in 1 immediately after the embolization. There were no complications, such as coils protrusion into the parent arteries, aneurysmal rupture, intrastent thrombosis and so on in all the patients. The following-up data showed that no rebleeding and cerebral ischemic complications were observed. The prognoses were modified Rankin scale 0 point in 12 patients, 1 point in 3 and 2 points in 1. Two patients with recurrent aneurysms were cured after stent-assisted coils embolization. Conclusions The endovascular embolization of the A1 segments aneurysms of the ACA is safe and effective. The various ancillary techniques and methods are necessary for the operator to ensure the successful embolization. The long-term effects of the endovascular embolization on ACA A1 segments aneurysms should be further observed.