title: Analysis of Clip-induced Ischemic Complication of Anterior Choroidal Artery Aneurysms.
abstract: OBJECTIVE
  The surgical approach is typically similar to those used for other supraclinoid internal carotid artery (ICA) lesions. However, the surgical clipping of this aneurysm is complicated and as a result, can result in postoperative ischemic complications. We studied to clarify the clip-induced ischemic complication risk of AChA aneurysm and to get the benefits for helping decision making.
  
  
  METHODS
  We retrospectively investigated 53 cases (4.0%) of AchA aneurysm treated surgically. We divided the AChA aneurysm to 3 subtype according to the origin of aneurysmal neck; A type originating from the AChA itself, J type from junction of AChA and ICA, and I type from the ICA itself. We evaluated brain CT about 1 week post-operative day to confirm the low density in AChA territory.
  
  
  RESULTS
  Ruptured aneurysm was 26 cases and unruptured aneurysm 27 cases. The aneurysmal subtype of A, J, and I was 13, 17, and 23 cases. Of the 53 cases who performed surgical neck clipping, twelve (22.6%) had postoperative AChA distribution infarcts. Increased infarct after neck clipping had statistic significance in non-I subtype (p=0.005).
  
  
  CONCLUSIONS
  It is easy to classify as "easy" surgery. But surgery for AChA aneurysms carries with it a significant risk of postoperative stroke. Don't always stick to clipping only, especially in non-I type of incidental small aneurysm, which has high risk of post-clip ischemic complications.
authors.affiliation: Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea.
authors.forename: Min-Soo
authors.initials: MS
authors.lastname: Cho
authors.forename: Min-Su
authors.initials: MS
authors.lastname: Kim
authors.forename: Chul-Hoon
authors.initials: CH
authors.lastname: Chang
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Kim
authors.forename: Byung-Yon
authors.initials: BY
authors.lastname: Choi