title: "Kissing aneurysms" of the anterior communicating artery treated with coil embolization.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Ehime Prefectural Central Hospital, Japan. hiroaki@m.ehime-u.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takechi
authors.forename: Kanehisa
authors.initials: K
authors.lastname: Kohno
authors.forename: Ushio
authors.initials: U
authors.lastname: Sasaki
mesh_terms: 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