Abstract
BackgroundThe information available about the variations and anatomy of the anterior choroidal artery (AchA) with aneurysm at the origin of the vessel and the outcomes of endovascular treatment (EVT) for AchA aneurysms is incomplete.Materials and MethodsA retrospective study of 54 consecutive patients who were admitted to our hospital with a diagnosis of AchA aneurysm and treated with EVT was performed. The variations and anatomy of the AchA and the outcomes of EVT for AchA aneurysms were analyzed.ResultThe 54 patients were aged 35–82 years (mean age, 56.1 ± 19.7 years) and included 32 females (59.3%, 32/54). Regarding AchA anatomy, 63.5% of AchAs had a typical S-shaped course. The diameter of the AchA origin averaged 0.8 ± 0.3 mm. Of all the AchA aneurysms, 51.9% were ruptured. The diameter of AchA aneurysms averaged 4.1 ± 2.4 mm. Moreover, 40.7% of 54 cases had multiple aneurysms. EVT was assisted with stenting for 25.9% of 54 AchA aneurysms. An immediate Modified Raymond-Roy Classification grade of I was obtained in 96.3% of AchA aneurysm cases. After EVT, the ischemic complication rate was 13%. In total, 83% of patients had good outcomes, with a Glasgow Outcome Scale score of 4–5. Follow-up angiography showed acceptable treatment results in this study.ConclusionThe study showed that the AchA had a complex angiographic anatomy in cases with aneurysms at the origin of the vessel and that the anatomical features can be helpful in EVT. EVT for aneurysms at the origin of the AchA had good outcomes.
Highlights
The anterior choroidal artery (AchA) is the branch arising from the internal carotid artery (ICA) after the origin of the posterior communicating artery (PcomA); it is a very important small vessel and has a complex anatomy [1, 2]
During endovascular treatment (EVT), one AchA was found to be occluded, and tirofiban was given; no angiographic improvement was obtained, and no new deficit was observed after EVT (Figure 7)
When EVT was finished, an immediate MRCC grade I was obtained for 52 AchA aneurysms (96.3%, 52/54), and grade II was obtained for two aneurysms (3.7%, 2/54)
Summary
The anterior choroidal artery (AchA) is the branch arising from the internal carotid artery (ICA) after the origin of the posterior communicating artery (PcomA); it is a very important small vessel and has a complex anatomy [1, 2]. The available data on AchA anatomy are mainly derived from studies of human anatomical specimens, intraoperative AchA observations or angiographic examinations in normal populations [4–7]. The available information about the variations and anatomy of the AchA with aneurysm is incomplete. This study examined the anatomy of the AchA in cases with an aneurysm at the origin of this vessel. The information available about the variations and anatomy of the anterior choroidal artery (AchA) with aneurysm at the origin of the vessel and the outcomes of endovascular treatment (EVT) for AchA aneurysms is incomplete
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