The Efficacy of Simultaneous Bilateral Internal Carotid Angiography during Coil Embolization for Anterior Communicating Artery Aneurysms.
10.3340/jkns.2011.49.5.257
- Author:
Soon Chan KWON
1
;
Jun Bum PARK
;
Shang Hun SHIN
;
Hong Bo SIM
;
In Uk LYO
;
Young KIM
Author Information
1. Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. nskwon.sc@gmail.com
- Publication Type:Original Article
- Keywords:
Coil embolization;
A-com artery;
Aneurysm;
Bilateral carotid angiography
- MeSH:
Aneurysm;
Angiography;
Arteries;
Carotid Artery, Internal;
Humans;
Intracranial Aneurysm;
Neck;
Retrospective Studies
- From:Journal of Korean Neurosurgical Society
2011;49(5):257-261
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Successful coil embolization of anterior communicating (A-com) artery aneurysms requires good visualization and understanding of the entire H complex. Bilateral carotid angiography may optimize anatomical understanding and visualization of the H complex. We therefore assessed the efficacy of simultaneous bilateral internal carotid angiography during coil embolization for A-com artery aneurysms. METHODS: Of the 153 patients with intracranial saccular aneurysms who underwent embolization between July 2008 and December 2009, 12 had A-com artery aneurysms and were embolized under bilateral carotid angiography. Patients were evaluated angiographically, immediately and 6 months (n=11) after embolization, using a 3-point scale (complete, residual neck, residual aneurysm). The safety, performance and efficacy of this approach were retrospectively evaluated. RESULTS: In all patients, bilateral internal carotid artery angiography provided more detailed anatomical information and understanding around the A-com artery, and, in complex situations, it allowed for more effective coil embolization through bilateral routes to the A-com artery. Angiography immediately after embolization showed occlusion of 11 of the 12 (92%) aneurysms, with none of these 11 showing evidence of recanalization at 6 months. CONCLUSION: These findings indicate that simultaneous bilateral carotid angiography during coil embolization of selected complex A-com artery aneurysms provided improved anatomical understanding, and resulted in more effective and safer procedures than typical unilateral angiography.
