title: Endovascular Coil Embolization of Distal Anterior Cerebral Artery Aneurysms: Angiographic and Clinical Follow-up Results.
abstract: OBJECTIVE
  This study is an overview of the clinical and angiographic outcomes of patients who undergo treatment for distal anterior cerebral artery aneurysms.
  
  
  METHODS
  Between January 2009 and March 2012, 444 cerebral aneurysms were treated using endovascular coil embolization at our institute. Among them, 217 aneurysms were followed-up with angiography at least six months later. Of these, there were 16 distal anterior cerebral artery (ACA) aneurysms in 16 patients. We conducted a retrospective review of clinical and radiological follow-up results of all patients with distal ACA aneurysms. The clinical and angiographic outcomes were assessed using the modified Rankin scale (mRS) and the Raymond classification scale, respectively.
  
  
  RESULTS
  The mean age was 54.7 ± 10.2 years (41-75 years). The mean follow-up period was 20.6 ± 9.64 months (6-37 months). Three patients presented with acute rupture. The average aneurysm size was 4.98 ± 1.39 mm (3.0-8.1 mm), and eight of 16 aneurysms (50%) had aspect ratios < 2.0. All 16 patients presented with complete obliteration immediately after the procedure. However, two patients had procedure-related complications, one with coil extrusion to the subarachnoid space without hemorrhage and one with thromboembolism subsequent to chemical thrombolysis. In the follow-up angiography, one major and five minor recurrences (for a total of six recurrences, 37.5%) were detected. However, the differences between the ACA aneurysm group and others were not statistically significant. Clinical outcomes were good for all of the patients at the time of discharge (mean mRS: 0.25, 0 to 1) and at the follow-ups (mean mRS: 0).
  
  
  CONCLUSIONS
  Despite a comparatively high recurrence rate, the endovascular treatment of distal anterior cerebral aneurysms is feasible and has a good clinical outcome.
authors.affiliation: Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Hyun Seok
authors.initials: HS
authors.lastname: Park
authors.forename: Soon Chan
authors.initials: SC
authors.lastname: Kwon
authors.forename: Min-Ho
authors.initials: MH
authors.lastname: Kim
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Park
authors.forename: Hong Bo
authors.initials: HB
authors.lastname: Sim
authors.forename: In Uk
authors.initials: IU
authors.lastname: Lyo
keywords: Aneurysm; Distal anterior cerebral artery; Endovascular coil embolization; Recurrence
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