title: [Case allocation in the management of ruptured anterior communicating aneurysm using endovascular embolization as a first option].
abstract: 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.
authors.affiliation: Department of Neurosurgery, Teine Keijinkai Hospital, Maeda 1 jo 12 chome 1-40, Teine-ku, Sapporo 006-8555, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kazumata
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ushikoshi
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Terasaka
authors.forename: Jurou
authors.initials: J
authors.lastname: Sakurai
authors.forename: Osamu
authors.initials: O
authors.lastname: Kikuchi
authors.forename: Yuka
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Katuyuki
authors.initials: K
authors.lastname: Asaoka
authors.forename: Kouji
authors.initials: K
authors.lastname: Itamoto
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Maruichi
mesh_terms: 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