title: Patency of the anterior choroidal artery covered with a flow-diverter stent.
abstract: OBJECTIVE
  The concept of the flow-diverter stent (FDS) is to induce aneurysmal thrombosis while preserving the patency of the parent vessel and any covered branches. In some circumstances, it is impossible to avoid dangerously covering small branches, such as the anterior choroidal artery (AChA), with the stent. In this paper, the authors describe the clinical and angiographic effects of covering the AChA with an FDS.
  
  
  METHODS
  Between April 2011 and July 2013, 92 patients with intracranial aneurysms were treated with the use of FDSs in the authors' institution. For 20 consecutive patients (21.7%) retrospectively included in this study, this involved the unavoidable covering of the AChA with a single FDS during endovascular therapy. AChAs feeding the choroid plexus were classified as the long-course group (14 cases), and those not feeding the choroid plexus were classified as the short-course group (6 cases). Clinical symptoms and the angiographic aspect of the AChA were evaluated immediately after stent delivery and during follow-up. Neurological examinations were performed to rule out hemiparesis, hemihypesthesia, hemianopsia, and other cortical signs.
  
  
  RESULTS
  FDS placement had no immediate effect on AChA blood flow. Data were obtained from 1-month clinical follow-up in all patients and from midterm angiographic follow-up in 17 patients (85.0%), with a mean length of 9.8 ± 5.4 months. No patient in either group complained of transient or permanent symptoms related to an AChA occlusion. In all cases, the AChA remained patent without any flow changes.
  
  
  CONCLUSIONS
  The results of this study suggest that when impossible to avoid, the AChA may be safely covered with a single FDS during intracranial aneurysm treatment, irrespective of anatomy and anastomoses.
authors.affiliation: Interventional Neuroradiology NEURI Center, Beaujon Hospital, Paris Diderot University, Clichy, France.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Neki
authors.affiliation: Interventional Neuroradiology NEURI Center, Beaujon Hospital, Paris Diderot University, Clichy, France.
authors.forename: Jildaz
authors.initials: J
authors.lastname: Caroff
authors.affiliation: Interventional Neuroradiology NEURI Center, Beaujon Hospital, Paris Diderot University, Clichy, France.
authors.forename: Pakrit
authors.initials: P
authors.lastname: Jittapiromsak
authors.affiliation: Interventional Neuroradiology NEURI Center, Beaujon Hospital, Paris Diderot University, Clichy, France.
authors.forename: Nidhal
authors.initials: N
authors.lastname: Benachour
authors.affiliation: Interventional Neuroradiology NEURI Center, Beaujon Hospital, Paris Diderot University, Clichy, France.
authors.forename: Cristian
authors.initials: C
authors.lastname: Mihalea
authors.affiliation: Interventional Neuroradiology NEURI Center, Beaujon Hospital, Paris Diderot University, Clichy, France.
authors.forename: Leon
authors.initials: L
authors.lastname: Ikka
authors.affiliation: Interventional Neuroradiology NEURI Center, Beaujon Hospital, Paris Diderot University, Clichy, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Moret
authors.affiliation: Interventional Neuroradiology NEURI Center, Beaujon Hospital, Paris Diderot University, Clichy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Spelle
mesh_terms: D000328:Adult; D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D002560:Cerebrovascular Circulation / Q000502:physiology; D002831:Choroid Plexus / Q000098:blood supply*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology*; D055815:Young Adult
keywords: AChA = anterior choroidal artery; FDS = flow-diverter stent; ICA = internal carotid artery; MCA = middle cerebral artery; aneurysm; anterior choroidal artery; flow-diverter stent; vascular disorders