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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleNeurointervention

Endovascular Parent Artery Occlusion for the Treatment of Wide-Neck A1 Segment Aneurysms: A Single-Center Experience

E. Tollard, L. Niemtschik, T.E. Darsaut, F. Guilbert, D. Roy, J. Raymond and A. Weill
American Journal of Neuroradiology January 2011, 32 (1) 174-178; DOI: https://doi.org/10.3174/ajnr.A2222
E. Tollard
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L. Niemtschik
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T.E. Darsaut
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F. Guilbert
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D. Roy
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J. Raymond
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A. Weill
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Abstract

SUMMARY: The goal of this study was to evaluate the feasibility and efficacy of A1 occlusion at the level of wide necked A1 aneurysms, where there are bilateral patent A1 segments and a patent AcomA. Between 2000 and 2010, 9 patients with wide necked A1 aneurysms were treated by coiling of the aneurysm along with parent vessel occlusion. All aneurysms had a wide neck (≥4mm). None were treated in the acute phase of a subarachnoid hemorrhage. Three small infarcts were noted on routine post-treatment head CT, 1 of which was symptomatic (transient hemiparesthesia). On control angiogram at 6 months or more, 3 A1 recanalizations were found, 2 of which had a stable small neck recurrence. None of the aneurysms ruptured on follow-up. In this series, parent artery occlusion was effective in treating wide-necked aneurysms arising from the A1 segment in patients with adequate collateral supply.

Abbreviations

A1
the first segment of the ACA up to the AcomA
A2
the second segment of the ACA from the AcomA to the genu of the corpus callosum
ACA
anterior cerebral artery
AcomA
anterior communicating artery
c
coiling
Dist
distal third of the A1
DSA
digital subtraction angiography
EVT
endovascular treatment
FU
follow-up
L
left
MD
maximum diameter
Mid
middle third of the A1
MRA
MR angiography
N
neck
OD
oculi dexter (right eye)
Prox
proximal third of the A1
R
right
RAH
recurrent artery of Heubner
s
surgery
SAH
subarachnoid hemorrhage
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American Journal of Neuroradiology: 32 (1)
American Journal of Neuroradiology
Vol. 32, Issue 1
1 Jan 2011
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Cite this article
E. Tollard, L. Niemtschik, T.E. Darsaut, F. Guilbert, D. Roy, J. Raymond, A. Weill
Endovascular Parent Artery Occlusion for the Treatment of Wide-Neck A1 Segment Aneurysms: A Single-Center Experience
American Journal of Neuroradiology Jan 2011, 32 (1) 174-178; DOI: 10.3174/ajnr.A2222

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Endovascular Parent Artery Occlusion for the Treatment of Wide-Neck A1 Segment Aneurysms: A Single-Center Experience
E. Tollard, L. Niemtschik, T.E. Darsaut, F. Guilbert, D. Roy, J. Raymond, A. Weill
American Journal of Neuroradiology Jan 2011, 32 (1) 174-178; DOI: 10.3174/ajnr.A2222
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