[Case allocation in the management of ruptured anterior communicating aneurysm using endovascular embolization as a first option].
OBJECTIVE
The management of ruptured anterior communicating aneurysms remains controversial since the results of ISAT have been reported. The aim of our study is to report our decision-making process and outcome in 36 consecutive cases using endovascular coil embolization as a first choice of treatment.


METHODS
Thirty-six patients were studied. Since April, 2004, the treatment modality has been decided after discussion between the endovascular and cerebrovascular surgeons, taking into account the physiological status, treatment risk and morphology of the aneurysm.


RESULTS
Twelve (33%) of 36 patients were allocated to coil embolization. Factors leading to the selection of clipping surgery were decided mostly by the morphology of the aneurysm, namely, tiny in 11 (47.8%), irregular shape in 6 (26.1%), broad neck in 3 (13.0%) and bleb located at the neck in 3 (13.0%). Half of the aneurysms projecting anteriorly were treated coil embolization.


CONCLUSIONS
The allocation rate of endovascular treatment in ruptured anterior communicating aneurysms was 33%. Endovascular treatment was effective in at least half of the anterior the projecting aneurysms.
Kazumata
Ken
K
Department of Neurosurgery, Teine Keijinkai Hospital, Maeda 1 jo 12 chome 1-40, Teine-ku, Sapporo 006-8555, Japan.
Ushikoshi
Satoshi
S
Terasaka
Shunsuke
S
Sakurai
Jurou
J
Kikuchi
Osamu
O
Yokoyama
Yuka
Y
Asaoka
Katuyuki
K
Itamoto
Kouji
K
Maruichi
Katsuhiko
K
D017542:Aneurysm, Ruptured / Q000628:therapy*; D003657:Decision Making; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome