title: Patency of the anterior choroidal artery after flow-diversion treatment of internal carotid artery aneurysms.
abstract: OBJECTIVE
  Treatment of cerebral aneurysms with flow diverters often mandates placement of the device across the ostia of major branches of the internal carotid artery. We determined the patency rates of the anterior choroidal artery after placement of flow-diversion devices across its ostium.
  
  
  METHODS
  We analyzed a consecutive series of patients in whom a Pipeline Embolization Device was placed across the ostium of an angiographically visible anterior choroidal artery while treating the target aneurysm. Patency of the anterior choroidal artery after Pipeline Embolization Device placement was determined at immediate postoperative and follow-up angiography. Data on pretreatment aneurysm rupture status, concomitant coiling, number of Pipeline Embolization Devices used, neurologic status at follow-up, and follow-up MR imaging/CT findings were collected.
  
  
  RESULTS
  Fifteen patients with 15 treated aneurysms were included in this study. In the immediate postprocedural setting, the anterior choroidal artery was patent on posttreatment angiography for all 15 patients. Of the 14 patients with follow-up angiography at least 6 months after Pipeline Embolization Device placement, 1 (7%) had occlusion of the anterior choroidal artery and 14 had a patent anterior choroidal artery (93%). No patients had new neurologic symptoms or stroke related to anterior choroidal artery occlusion at follow-up. Of the 9 patients with follow-up CT or MR imaging, none had infarction in the vascular territory of the anterior choroidal artery.
  
  
  CONCLUSIONS
  In this small study, placement of a Pipeline Embolization Device across the anterior choroidal artery ostium resulted in occlusion of the artery in only 1 patient. It was not associated with ischemic changes in the distribution of the anterior choroidal artery in any patient.
authors.affiliation: From the Departments of Radiology (W.B., D.F.K., H.J.C., G.L.) Brinjikji.waleed@mayo.edu.
authors.forename: W
authors.initials: W
authors.lastname: Brinjikji
authors.affiliation: From the Departments of Radiology (W.B., D.F.K., H.J.C., G.L.) Neurosurgery (D.F.K., H.J.C., G.L.), Mayo Clinic, Rochester, Minnesota.
authors.forename: D F
authors.initials: DF
authors.lastname: Kallmes
authors.affiliation: From the Departments of Radiology (W.B., D.F.K., H.J.C., G.L.) Neurosurgery (D.F.K., H.J.C., G.L.), Mayo Clinic, Rochester, Minnesota.
authors.forename: H J
authors.initials: HJ
authors.lastname: Cloft
authors.affiliation: From the Departments of Radiology (W.B., D.F.K., H.J.C., G.L.) Neurosurgery (D.F.K., H.J.C., G.L.), Mayo Clinic, Rochester, Minnesota.
authors.forename: G
authors.initials: G
authors.lastname: Lanzino
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging; D001158:Arteries / Q000502:physiology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D054022:Cerebrum / Q000098:blood supply*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014654:Vascular Patency