title: The Efficacy of Simultaneous Bilateral Internal Carotid Angiography during Coil Embolization for Anterior Communicating Artery Aneurysms.
abstract: OBJECTIVE
  Successful coil embolization of anterior communicating (A-com) artery aneurysms requires good visualization and understanding of the entire H complex. Bilateral carotid angiography may optimize anatomical understanding and visualization of the H complex. We therefore assessed the efficacy of simultaneous bilateral internal carotid angiography during coil embolization for A-com artery aneurysms.
  
  
  METHODS
  Of the 153 patients with intracranial saccular aneurysms who underwent embolization between July 2008 and December 2009, 12 had A-com artery aneurysms and were embolized under bilateral carotid angiography. Patients were evaluated angiographically, immediately and 6 months (n=11) after embolization, using a 3-point scale (complete, residual neck, residual aneurysm). The safety, performance and efficacy of this approach were retrospectively evaluated.
  
  
  RESULTS
  In all patients, bilateral internal carotid artery angiography provided more detailed anatomical information and understanding around the A-com artery, and, in complex situations, it allowed for more effective coil embolization through bilateral routes to the A-com artery. Angiography immediately after embolization showed occlusion of 11 of the 12 (92%) aneurysms, with none of these 11 showing evidence of recanalization at 6 months.
  
  
  CONCLUSIONS
  These findings indicate that simultaneous bilateral carotid angiography during coil embolization of selected complex A-com artery aneurysms provided improved anatomical understanding, and resulted in more effective and safer procedures than typical unilateral angiography.
authors.affiliation: Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Soon Chan
authors.initials: SC
authors.lastname: Kwon
authors.forename: Jun Bum
authors.initials: JB
authors.lastname: Park
authors.forename: Shang Hun
authors.initials: SH
authors.lastname: Shin
authors.forename: Hong Bo
authors.initials: HB
authors.lastname: Sim
authors.forename: In Uk
authors.initials: IU
authors.lastname: Lyo
authors.forename: Young
authors.initials: Y
authors.lastname: Kim