"Kissing aneurysms" of the anterior communicating artery treated with coil embolization.
OBJECTIVE
To present a case of kissing aneurysms of the anterior communicating artery treated with endovascular coil embolization and discuss the advantages and disadvantages of this technique compared with neck clipping.


METHODS
A 48-year-old man became drowsy and was admitted to the hospital; he had right hemiparesis and aphasia. Computed tomography revealed diffuse subarachnoid hemorrhage; diagnostic angiography identified an aneurysm at the left A1-A2 junction of the anterior communicating artery and another in the distal anterior cerebral artery (ACA). Endovascular coil embolization was performed on the same day. During the procedure, the 3-mm-diameter junctional aneurysm was successfully packed with coils, but an additional aneurysm was suspected; right carotid angiography following embolization of the left aneurysm clearly showed a mirror image aneurysm of the right A1-A2 junction. The right aneurysm was treated using the same technique. The broad-necked ACA aneurysm was unsuitable for embolization, so neck clipping was performed 5 weeks later. The patient was discharged to his home following complete recovery 7 weeks after the coil embolization.


CONCLUSIONS
Kissing aneurysms are a rare and specific type of multiple aneurysms that require caution in diagnosis and surgical management. Endovascular treatment may be suitable because it does not involve dissection around the aneurysms.
Matsumoto
Hiroaki
H
Department of Neurosurgery, Ehime Prefectural Central Hospital, Japan. hiroaki@m.ehime-u.ac.jp
Takechi
Akihiko
A
Kohno
Kanehisa
K
Sasaki
Ushio
U
D020771:Anterior Cerebral Artery; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology