Feasibility & Limitations of Endovascular Coil Embolization of Anterior Communicating Artery Aneurysms

OBJECTIVE: The purpose of this study is to analyze aneurysm morphology and define limitations and feasibility in endovascular Gugliemi detachable coil(GDC) embolization for anterior communicating artery (ACoA) aneurysms. METHODS: From January 2000 through October 2003, 123patients were treated with endovascular coil embolization for ACoA aneurysms. There were 75women and 48men, with a mean age of 63years. All ruptured aneurysms were treated within 15days of rupture. Aneurysm morphology was classified according to neck size and projection of aneurysm dome as follows - A: neck of aneurysm or =4mm) aneurysms are highly related to recanalization of aneurysms. CONCLUSION: Endovascular coil embolization of ACoA aneurysms shows good outcome in our study. Nevertheless, there is a limitation in the endovascular approach to ACoA, even though advanced modern techniques evolve rapidly. Compensatory surgical approach with the endovascular approach is required for successful treatment of ACoA aneurysms.

Failed GDC Embolization for Aneurysms Arising at the Fenestrated Anterior Communicating Artery

Fenestration of anterior communicating artery is one of relatively common anomalies. It is not always possible to check all of the anomalies in the anterior communicating artery by conventional angiogram. In case of coil embolization on aneurysm located in anterior communicating artery, the fenestration may cause unexpected complications. The evidential example taken here shows a 41-year-old patient with an anterior communicating artery aneurysm, on whom GDC embolization failed due to coil migration and ligation of aneurysm was given in a surgical treatment. The operative findings led to the discovery of the unexpected fenestration of anterior communicating artery and two separate aneurysms arising at each side of the fenestrated anterior communicating artery. A great concern should be given in coil embolization of aneurysms arising at the anterior communicating arteries.