title: Stent-assisted embolization of wide-neck anterior communicating artery aneurysms: Review of consecutive 34 cases.
abstract: OBJECTIVE
  We report our experience with stent-assisted coiling of anterior communicating artery aneurysms with special consideration of angiographic and clinical outcomes, retreatment rate and periprocedural complications.
  
  
  METHODS
  The analysis included 34 consecutive ruptured and unruptured wide-neck aneurysms. The aneurysm size ranged from 2 to 18mm (mean 5.47). Clinical examinations with the use of modified Rankin Score and angiographic outcomes were evaluated initially post-embolization and at a minimum follow-up of 6 months.
  
  
  RESULTS
  Initial post-treatment complete and near-complete aneurysm occlusion was achieved in 32 (94%) and 2 (6%) cases, respectively. Imaging follow-up, performed in 28 (82%) patients, showed no change in the degree of occlusion in 25 (89%) cases and coil compaction in 3 (11%) patients. Of these, one (3.6%) patient underwent a second coil embolization. The periprocedural severe complication rate was 2.9% (1/35) and was associated with prolonged attempt of retrieval of migrated coil resulting in anterior cerebral artery infarct with serious clinical consequences. In another 3 patients periprocedural adverse events without delayed clinical consequences were noticed. The clinical follow-up evaluation achieved in 33 (97%) patients showed no change in 30 (91%) cases, one patient (3%) with clinical improvement and two (6%) cases of neurological deterioration.
  
  
  CONCLUSIONS
  The use of stent is feasible and effective for coil embolization of wide-necked anterior communicating artery aneurysms. Although periprocedural complications resulting in severe morbidity are rare, they should be noted, since in terms of thromboembolic events some of them presumably have a potential to be avoidable.
authors.affiliation: Department of Neurosurgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland. Electronic address: damkocur@gmail.com.
authors.forename: Damian
authors.initials: D
authors.lastname: Kocur
authors.affiliation: Department of Radiology and Nuclear Medicine, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Miłosz
authors.initials: M
authors.lastname: Zbroszczyk
authors.affiliation: Department of Neurosurgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Nikodem
authors.initials: N
authors.lastname: Przybyłko
authors.affiliation: Department of Neurosurgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Hofman
authors.affiliation: Department of Neurosurgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Jamróz
authors.affiliation: Department of Radiology and Nuclear Medicine, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Baron
authors.affiliation: Department of Neurosurgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Bażowski
authors.affiliation: Department of Neurosurgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Kwiek
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Anterior communicating artery aneurysm; Stent-assisted embolization; Wide-neck aneurysm