title: Eleven Year's Single Center Experience of Endovascular Treatment of Anterior Communicating Artery Aneurysms: Focused on Digital Subtraction Angiography Follow-Up Results.
abstract: OBJECTIVE
  Anterior communicating artery (AcomA) aneurysms represent the most common intracranial aneurysms and challenging to treat due to complex vascularity. The purpose of this study was to report our experience of endovascular treatment of AcomA aneurysms.
  
  
  METHODS
  Between January 2003 and December 2013, we retrospectively reviewed the medical records of 134 AcomA aneurysm patients available more than 6 months conventional angiographic and clinical follow-up results. We focused on aneurismal or AcomA vascular characters, angiographic and clinical follow-up results, and retreatment.
  
  
  RESULTS
  The rate of ruptured cases was 75.4%, and the small (<10 mm) aneurysms were 96.3%. Based on the subtypes defined by dominance of A1, 79 patients (59%) had contralateral A1 hypoplasia or agenesis. The immediate post-procedural angiography confirmed complete occlusion in 75.4%, partial occlusion in 24.6%. Procedure related complications were observed in 25 (18.6%) patients. Most of the adverse events were asymptomatic. Follow-up conventional angiography at ≥6 months was performed in all patients (mean 16.3 months) and major recanalization was noted in 6.7% and regrowth in one case. The aneurysm size (p=0.016), and initial treatment results (p=0.00) were statistically significant risk factors related to aneurysm recurrence. An overall improvement in mRS was observed during the clinical follow-up period and no rebleeding episode occurred.
  
  
  CONCLUSIONS
  This study demonstrated that endovascular treatment is an effective treatment modality for AcomA aneurysms with low morbidity. Patients should take long term clinical and angiographic follow-up in order to assess the recurrence and warrant retreatment, especially ruptured, large, and initially incomplete occluded aneurysms.
authors.affiliation: Department of Neurosurgery, Medical Research Institute, Pusan National University School of Medicine, University Pusan National University Hospital, Busan, Korea.
authors.forename: Chae Wook
authors.initials: CW
authors.lastname: Hur
authors.affiliation: Department of Neurosurgery, Medical Research Institute, Pusan National University School of Medicine, University Pusan National University Hospital, Busan, Korea.
authors.forename: Chang Hwa
authors.initials: CH
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Medical Research Institute, Pusan National University School of Medicine, University Pusan National University Hospital, Busan, Korea.
authors.forename: Seung Heon
authors.initials: SH
authors.lastname: Cha
authors.affiliation: Department of Diagnostic Radiology, Medical Research Institute, Pusan National University School of Medicine, University Pusan National University Hospital, Busan, Korea.
authors.forename: Tae Hong
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Department of Diagnostic Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Hae Woong
authors.initials: HW
authors.lastname: Jeong
authors.affiliation: Department of Neurosurgery, Medical Research Institute, Pusan National University School of Medicine, University Pusan National University Hospital, Busan, Korea.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Lee
keywords: Anterior communicating artery aneurysm; DSA follow up; Endovascular treatment