title: [Endovascular treatment of ruptured aneurysms located at anterior communicating artery complex: a sixty-six cases report].
abstract: OBJECTIVE
  To investigate the endovascular treatments for the ruptured aneurysms located at anterior communicating artery complex (ACoAC).
  
  
  METHODS
  The data of patients with ruptured ACoAC aneurysms treated in Department of Neurosurgery, First Affiliated Hospital to Fourth Military Medical University from May 2013 to December 2014 was retrospectively analyzed. Sixty-six cases were recruited including 50 male and 16 female patients. The patients aged from 31 to 69 years old, averaging (51±8) years. The Hunt-Hess grade at admission were 13 cases with grade Ⅰ, 36 cases with grade Ⅱ, 11 cases with grade Ⅲ, and 6 cases with grade Ⅳ. The most diameter of aneurysms sac: 14 cases less than or equal to 3 mm, 36 cases more than 3 mm but less than or equal to 7 mm, and 16 cases more than 7 mm. The height diameter/neck width ratio: 8 cases with absolute wide neck, 50 cases with relatively wide neck, and 8 cases with narrow neck. There were 28 cases underwent single micro-catheter embolization, 18 cases underwent double micro-catheters embolization, 14 cases underwent stent-assisted embolization and 6 cases underwent balloon-assisted embolization. The patients were followed up for 6 to 12 months and evaluated by modified Rankin score (mRS) and digital subtraction angiography (DSA). The ratio of total embolization, recurrence rate, and time from operation to reexamination of four groups managed by different endovascular treatment were compared by χ(2) test or F test.
  
  
  RESULTS
  Sixty cases were totally embolized, 3 cases subtotally embolized, 3 cases incompletely embolized. Mild hemiparalysis and aphasia occurred in 2 cases, and 1 case died of infarction induced by subarachnoid haemorrhage. The mRS at six months after operation were 0 in 31 cases, 1 in 22 cases, 2 in 8 cases, 3 in 2 cases, 4 in 2 cases, 6 in 1 case. All the included cases reexamined the DSA at averaging (7.5±1.0) month post-operatively and 4 cases recurred. There were not significant differences of the ratio of total embolization, recurrence rate, time from operation to reexamination among four groups (all P>0.05).
  
  
  CONCLUSIONS
  The endovascular treatment maybe an ideal management for ruptured ACoAC aneurysms.
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital to Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.forename: Feng
authors.initials: F
authors.lastname: Han
authors.forename: Yanwei
authors.initials: Y
authors.lastname: Chen
authors.forename: Jun
authors.initials: J
authors.lastname: Tian
authors.forename: Zhenmin
authors.initials: Z
authors.lastname: Wang
authors.forename: Ping'an
authors.initials: P
authors.lastname: Sun
authors.forename: Minrui
authors.initials: M
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Cao
authors.forename: Yan
authors.initials: Y
authors.lastname: Han
authors.forename: Xiaofan
authors.initials: X
authors.lastname: Jiang
authors.forename: Zhou
authors.initials: Z
authors.lastname: Fei
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000628:therapy*; D057785:Catheters; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome