title: Endovascular treatment of A1 aneurysms of the anterior cerebral artery.
abstract: OBJECTIVE
  The aim of this study was to present the clinical and angiographic outcomes of A1 aneurysms treated by coil embolization.
  
  
  METHODS
  We retrospectively evaluated 38 consecutive patients with A1 aneurysm (20 ruptured and 18 unruptured; mean age, 53.8 ± 11.9 years) from 2011 to 2014 treated by an endovascular approach in our hospital. Follow-up angiography was obtained in 30 patients. Clinical outcomes were evaluated by modified Rankin Scale (mRS) over telephone.
  
  
  RESULTS
  Among the 38 patients, 24 were treated with single-catheter technique, 8 with stent-assisted coiling (Enterprise 3; Solitaire 5), 5 with parent vessel obliteration, and 1 with balloon-assisted coiling. Initial angiographic results revealed that complete occlusion was achieved in 21 aneurysms (55.3%), near-complete occlusion in 16 (42.1%), and partial occlusion with contrast agent filling the aneurysm sac in 1 (2.6%). Procedure-related complications were observed in 6 patients (15.8%). Follow-up angiographic imaging evaluation after coil embolization was performed in 32 aneurysms (mean interval, 22.6 ± 6.7 months), which showed that 31 (96.9%) aneurysms remained stable or improved without regrowth, while minor recanalization was found in 1 aneurysm (3.1%), which was treated by parent vessel occlusion. Clinical follow-up evaluation was excellent in 37 of the 38 patients (mRS score 0 in 34, and mRS score 1 in 3) at a mean duration of 26.6 ± 7.7 months.
  
  
  CONCLUSIONS
  Endovascular treatment is feasible and effective for A1 segment aneurysms. The current treatment selections, including single-catheter embolization, balloon-assisted coiling, stent-assisted coiling, and parent vessel occlusion, should be performed according to the characteristics and morphology of A1 aneurysms.
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xianli
authors.initials: X
authors.lastname: Lv
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Youxiang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Lv
mesh_terms: D000328:Adult; D000368:Aged; D020771:Anterior Cerebral Artery; D001807:Blood Vessel Prosthesis; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome