title: Endovascular treatment of anterior cerebral artery aneurysms using Guglielmi detachable coils: mid-term clinical evaluation.
abstract: OBJECTIVE
  Clinical and angiographic evaluations were performed in 19 consecutive patients with anterior communicating artery (ACoA) aneurysms treated by Guglielmi detachable coil (GDC) embolization between March 1997 and April 1999.
  
  
  METHODS
  The angiographic criteria for endovascular treatment were 1) small (< 15 mm) aneurysm with a neck smaller than the fundus and 2) distinguishable aneurysm neck and relationship to the parent artery. Initially, we also included patients with anticipated surgical difficulties. These criteria were later expanded to include patients with conditions amenable to surgical clipping. Eleven patients presented with subarachnoid hemorrhage (SAH), and eight patients were asymptomatic. The most recent clinical follow-up was obtained by telephone interview with the patients and with their close relatives, to examine post-treatment personality changes.
  
  
  RESULTS
  Complete obliteration (68%) or near-complete obliteration (neck remnant) (32%) of the ACoA aneurysm was achieved in all patients. Six-month follow-up angiography performed in 15 patients demonstrated no recurrence of aneurysms. The clinical outcome was good recovery in 15 (80%), moderately disabled in one (5%), vegetative survival in one (5%), and death in two (10%). The patients who had good recovery did not demonstarate significant personality or behavioral change. No late rebleeding had occurred at the time of writing, a minimum of 33 months postoperatively.
  
  
  CONCLUSIONS
  The outcome of endovascular treatment of ACoA aneurysms was satisfactory, especially in post-treatment psychosocial sequelae.
authors.affiliation: Department of Neurosurgery, Chikushi Hospital, Fukuoka University, Chikushino-shi, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kazekawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Tsutsumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikawa
authors.forename: Minoru
authors.initials: M
authors.lastname: Iko
authors.forename: Akira
authors.initials: A
authors.lastname: Tanaka
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Go
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Kawano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020771:Anterior Cerebral Artery; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013997:Time Factors