title: Superior hypophyseal artery aneurysms have the lowest recurrence rate with endovascular therapy.
abstract: OBJECTIVE
  Given the challenges posed by surgical clipping, endovascular techniques have been increasingly used to treat SHA aneurysms. The purpose of this study was to assess the safety and efficacy of endovascular techniques in the treatment of SHA aneurysms.
  
  
  METHODS
  Medical charts and initial and follow-up angiograms were reviewed retrospectively for all patients treated with endovascular procedures at our institution between January 2006 and February 2011.
  
  
  RESULTS
  We identified 87 patients with SHA aneurysms who were treated with endovascular techniques. Of these patients, 79 were women and only 8 were men (90.8% female predominance). Thirty-five patients were treated with coil embolization; 45, with stent-assisted coiling; 4, with balloon-assisted coil embolization; and 3, with a flow-diversion technique. Minor complications occurred in 2 patients (2.2%). None of the patients had a major complication. The mortality and permanent morbidity rates related to the procedure were 0%. Imaging follow-up was available for 89.4% of patients (DSA in 65, MRA in 11 patients) at a mean time point of 10.4 months (range, 6-60 months). Of the 76 patients with available follow-up, 3 patients had a recurrence (3.9%) and only 1 required further intervention (1.3%). Stent-assisted coiling was associated with lower recurrence rates than simple coil embolization.
  
  
  CONCLUSIONS
  SHA aneurysms have the lowest recurrence rate with endovascular treatment compared with aneurysms in other locations by using historical data. Because of its safety and efficacy, endovascular therapy should be considered the procedure of choice for the treatment of SHA aneurysms.
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PA 19107, USA.
authors.forename: N
authors.initials: N
authors.lastname: Chalouhi
authors.forename: S
authors.initials: S
authors.lastname: Tjoumakaris
authors.forename: A S
authors.initials: AS
authors.lastname: Dumont
authors.forename: L F
authors.initials: LF
authors.lastname: Gonzalez
authors.forename: C
authors.initials: C
authors.lastname: Randazzo
authors.forename: D
authors.initials: D
authors.lastname: Gordon
authors.forename: R
authors.initials: R
authors.lastname: Chitale
authors.forename: R
authors.initials: R
authors.lastname: Rosenwasser
authors.forename: P
authors.initials: P
authors.lastname: Jabbour
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000098:blood supply; D011859:Radiography; D012008:Recurrence; D015607:Stents