title: Endovascular treatment of aneurysms arising from the proximal segment of the anterior cerebral artery.
abstract: OBJECTIVE
  Aneurysms arising from the proximal segment of the anterior cerebral artery (A1) are rare and challenging to treat. The aim of this study was to report our experience with endovascular treatment of A1 Aneurysms.
  
  
  METHODS
  From August 2007 through May 2012, eleven A1 aneurysms in eleven patients were treated endovascularly. Six aneurysms were unruptured and 5 were ruptured. One patient with an unruptured A1 aneurysm presented with subarachnoid hemorrhage due to rupture of an anterior communicating artery aneurysm. Procedural data, clinical and angiographic results were reviewed retrospectively.
  
  
  RESULTS
  All of the aneurysms were successfully treated with coil embolization. Six were treated with a simple technique while the remaining 5 required adjunctive technique : double catheters (n=2), balloon-assisted (n=2), and stent-assisted (n=1). The immediate angiographic control showed a complete occlusion in all cases. Procedure-related complication occurred in only one patient : parent artery occlusion, which was not clinically significant. All patients had excellent clinical outcomes but one patient was discharged with a slight disability. No neurologic deterioration or bleeding was seen during the follow-up period in this cohort of patients. Follow-up angiography (mean, 20 months) was available in ten patients and revealed stable occlusion in all cases.
  
  
  CONCLUSIONS
  Endovascular treatment is a feasible and effective therapeutic modality for A1 aneurysms. Tailored microcatheter shaping and/or adjunctive techniques are necessary for successful aneurysm embolization because of the projection and location of A1 aneurysms.
authors.affiliation: Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Jun Kyeung
authors.initials: JK
authors.lastname: Ko
authors.forename: Seung Heon
authors.initials: SH
authors.lastname: Cha
authors.forename: Tae Hong
authors.initials: TH
authors.lastname: Lee
authors.forename: Chang Hwa
authors.initials: CH
authors.lastname: Choi
authors.forename: Sang Weon
authors.initials: SW
authors.lastname: Lee
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Lee
keywords: Anterior cerebral artery aneurysm; Endovascular treatment; Intracranial aneurysm