Arthur André1,2, Anne-Laure Boch3, Federico Di Maria4, Aurélien Nouet3, Nader Sourour4, Stéphane Clémenceau3, Joseph Gabrieli4, Vincent Degos5,6, Chiheb Zeghal5, Jacques Chiras4,6, Philippe Cornu3,6, Frédéric Clarençon4,6. 1. Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Assistance-Publique Hôpitaux de Paris, 47 boulevard de l'hôpital, 75013, Paris, France. arthur.andre@neurochirurgie.fr. 2. Pierre et Marie Curie University, Sorbonne Universités, Paris, France. arthur.andre@neurochirurgie.fr. 3. Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Assistance-Publique Hôpitaux de Paris, 47 boulevard de l'hôpital, 75013, Paris, France. 4. Department of Interventional Neuroradiology, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. 5. Department of Anesthesiology, Pitié-Salpêtrière University Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France. 6. Pierre et Marie Curie University, Sorbonne Universités, Paris, France.
Abstract
OBJECT: The anterior choroidal artery (AChoA) is a rare location for intracranial aneurysms. The treatment of these aneurysms may be challenging due to the risk of occlusion of such a small and eloquent artery as the AChoA. We aimed to evaluate the risk factors for complications in AChoA aneurysm treatment. METHODS: We retrospectively analyzed 47 consecutive AChoA aneurysms in 40 patients treated in our institution from 1999 and 2014 by endovascular means (87%) or surgical clipping (13%). Minor (transient or minor neurological deficits) and major complications (severe permanent neurological deficits or death) were systematically recorded. The influence of patient age, sex, aneurysm size, neck size, shape, dome-to-neck ratio and treatment technique on the occurrence of procedure-related complications was evaluated. RESULTS: Of the patients 11 experienced procedure-related complications (5 major, 6 minor). Aneurysms with multilobed shape were significantly associated with a higher procedure-related complication rate. There was a tendency for higher major procedure-related complication rate in small volume aneurysms. We did not find any association between the other factors analyzed and occurrence of procedure-related complications. CONCLUSION: Treatment of AChoA aneurysms has an acceptable complication risk. We did not find any significant differences between surgical and endovascular treatment in terms of procedure-related complication rates. Multilobed aneurysms were significantly associated with a higher procedure-related complication rate.
OBJECT: The anterior choroidal artery (AChoA) is a rare location for intracranial aneurysms. The treatment of these aneurysms may be challenging due to the risk of occlusion of such a small and eloquent artery as the AChoA. We aimed to evaluate the risk factors for complications in AChoA aneurysm treatment. METHODS: We retrospectively analyzed 47 consecutive AChoA aneurysms in 40 patients treated in our institution from 1999 and 2014 by endovascular means (87%) or surgical clipping (13%). Minor (transient or minor neurological deficits) and major complications (severe permanent neurological deficits or death) were systematically recorded. The influence of patient age, sex, aneurysm size, neck size, shape, dome-to-neck ratio and treatment technique on the occurrence of procedure-related complications was evaluated. RESULTS: Of the patients 11 experienced procedure-related complications (5 major, 6 minor). Aneurysms with multilobed shape were significantly associated with a higher procedure-related complication rate. There was a tendency for higher major procedure-related complication rate in small volume aneurysms. We did not find any association between the other factors analyzed and occurrence of procedure-related complications. CONCLUSION: Treatment of AChoA aneurysms has an acceptable complication risk. We did not find any significant differences between surgical and endovascular treatment in terms of procedure-related complication rates. Multilobed aneurysms were significantly associated with a higher procedure-related complication rate.
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