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  • Stent Assisted Coiling of Anterior Communicating Artery Aneurysms: A Single Center Experience in 19 Patients

    Final Number:
    988

    Authors:
    John Christos Styliaras BA, BS, MS, MD; David M. Hasan MD; Stavropoula I. Tjoumakaris MD; L. Fernando Gonzalez MD; Aaron S. Dumont MD; Robert H. Rosenwasser MD, FACS, FAHA; Pascal Jabbour MD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2011 Annual Meeting

    Introduction: Anterior communicating artery (Acomm) aneurysms are one of the most common intracranial aneurysms. Treatments include neurosurgical clipping or endovascular embolization, but there is a paucity of literature on stent assisted coiling of Acomm aneurysms.

    Methods: We reviewed the prospectively maintained database of patients that underwent stent assisted coiling of anterior communicating artery aneurysms. A total of 19 patients were treated with stent assisted coiling: 12 patients were treated status post subarachnoid hemorrhage and 7 patients were treated electively. We evaluated the clinical presentation, management, morphology of the aneurysms, technical feasibility of the procedure and clinical outcome of these patients.

    Results: Of the 19 patients included in the study, 12 were male, and 5 were female. The ages varied between 42 to 96 years old, while 5 had a prior history of hypertesion and 4 were current smokers, 2 were ex-smokers, and 13 patients never smoked tobacco. Post-operatively, there was no mortality, 16 patients had no complications, while 3 experienced some complications (15.79%). Of those complications, 1 patient developed pneumonia, 1 had seizures, and 2 patients exhibited vasospasm as measured through transcranial dopplers, 1 of which required intrarterial cardene injection and angioplasty. None of the patients required a decompressive hemicraniectomy, a vetriculoperitoneal shunt, nor experienced any complications such as myocardial infection, meningitis, sepsis, urinary tract infection, or deep vein thrombosis. 4 of the 19 patients have so far undergone follow-up angiogram showing 90-100% occlusion. As these patients were all treated between 2009 and 2010, occlusion rates on follow-up angiograms for the rest of the patients will be become available in the future.

    Conclusions: Stent assisted coiling of Acomm aneurysms is not adequately studied in current literature. Our single center experience of such treatment in 19 patients, showed it to be a feasible and safe method of treatment. In adequately selected patients. Our results are congruent with a small number of previously published data. Efficacy of treatment in terms of recurrence of Acomm aneurysms, can be further assessed in follow-up studies.

    Patient Care: By showing efficacy, safety, and technical feasability of stent assisted coil embolization of acomm aneurysms, it will add to a potentially growing body of evidence supporting this modality of treatment for acomm aneurysms.

    Learning Objectives: Our objective is to present a single center experience with stent assisted coiling of Acomm aneursyms. In this series, we present the results of endovascular treatment with stent assisted coiling of Acomm aneurysms in 19 patients between September 2009 and June 2010.

    References:

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