Technical analysis of endovascular embolization for ruptured tiny aneurysms of anterior communicating arteries / 中国脑血管病杂志

ABSTRACT

Objective To investigate the feasibility,efficacy and key points of individually designed endovascular embolization for ruptured tiny aneurysms of anterior communicating arteries. Methods The clinical,DSA imaging,interventional treatment and follow-up data of 21 patients with ruptured tiny aneurysms (21 aneurysms)of anterior communicating arteries from March 2009 to March 2014 were analyzed retrospectively. Thirteen of them were treated with coil embolization only,6 were embolized with microcatheter-assisted technique,and 2 were embolized with balloon-assisted technique. Results (1)One patient was failed to embolize because of technical reason. Immediate postoperative angiography found that in the other 20 patients14 were packed densely,6 had residual aneurysm necks. (2)Intraoperative complicationsOne patient had acute occlusion of ipsilateral anterior cerebral artery,the blood vessel was patent after thrombolytic method;2 patients had intraoperative ruptured aneurysm. (3)The modified Rankin scale (mRS)scores of 20 patients with successful embolization at discharge0-1 in 14 cases,2 in 4 cases, and 3-4 in 2 cases. (4)Follow-up study20 patients were followed up for 12 months after discharge. The mRS scores0-1 in 18 cases,2 in 1 case,and 3-4 in 1 case. Clinical follow-up for 6 to 60 months,no aneurysm ruptured. Fifteen patients were followed up for 6 to 60 months with DSA,one of them recurred,and he was treated with supplementary dense packing. Conclusion Endovascular embolization for ruptured tiny aneurysms of anterior communicating arteries is difficult,but it is feasible and effective. The proficient surgical skill,individualized surgical design and appropriate embolism are the keys to improve the embolization effect.