title: Endovascular coil embolization of middle cerebral artery aneurysms of the proximal (M1) segment.
abstract: BACKGROUND
  Proximal middle cerebral artery (M1 segment) aneurysms have various configurations and are distinct from middle cerebral artery bifurcation aneurysms. We present the clinical and radiological results of coil embolization of the M1 segment aneurysms.
  
  
  METHODS
  From a prospective database, we retrieved the data for 59 consecutive patients harboring 60 M1 aneurysms that were treated with endovascular coil embolization from January 2006 to May 2012. We assessed the clinical outcomes of the patients and morphological outcomes of the aneurysms using the Raymond classification.
  
  
  RESULTS
  The aneurysms were located on the superior wall of the M1 segment in 43 and on the inferior wall in 17. Superior-wall aneurysms were related to the frontal cortical artery and the lateral lenticulostriate perforator while inferior-wall aneurysms were to the temporal cortical artery. With coil embolization, complete aneurysmal occlusion or residual neck could be achieved in 52 aneurysms (86.7 %) and residual aneurysm in 8. The microcatheter protection technique was most commonly used for coil embolization (41.7 %) followed by single microcatheter (31.7 %), double microcatheter (23.3 %), and stent protection (3.3 %). There was no procedure-related morbidity or mortality. Follow-up angiography more than 6 months after embolization (n = 46; mean 12.4 months) demonstrated stable occlusion in 40 (87.0 %), minor recanalization in 4 (8.7 %), and major recanalization in 2 (4.3 %). One patient experienced delayed cerebral infarction without permanent neurologic deficit.
  
  
  CONCLUSIONS
  Coil embolization in M1 aneurysms seems to be safe and efficacious, although it may require various technical strategies due to distinct anatomic configurations.
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Cho
authors.forename: Woong Jae
authors.initials: WJ
authors.lastname: Lee
authors.forename: Kang Min
authors.initials: KM
authors.lastname: Kim
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Kang
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Han
mesh_terms: D002533:Cerebral Angiography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome