title: Stand-alone coil embolization of anterior communicating artery aneurysms: Efficacy and technical issues.
abstract: OBJECTIVE
  We report our experience with endovascular coiling of anterior communicating artery aneurysms with special consideration of angiographic and clinical outcomes and periprocedural complications.
  
  
  METHODS
  The analysis included treatment results of 28 patients with ruptured and unruptured aneurysms. The aneurysm size ranged from 1.8 to 9.8 mm (mean 5.2, SD 1.7). Clinical examinations with the use of modified Rankin Score and angiographic outcomes were evaluated initially post-embolization and at a minimum follow-up of six months.
  
  
  RESULTS
  Initial post-treatment complete and near-complete aneurysm occlusion was achieved in 27 (96%) cases and incomplete occlusion in one (4%) case. Imaging follow-up, performed in 15 (53.6%) patients, showed no change in the degree of occlusion in 11 (73%), coil compaction in one (7%) and progressive occlusion in three (20%) patients. Three (20%) patients underwent a second coil embolization. The procedure-related severe morbidity and mortality rate was 6.4% (2/31). Coil prolapse was present in one (3.2%) case and intraprocedural aneurysm rupture in three (9.6%) cases. The clinical follow-up evaluation achieved in 19 (67.9%) patients showed no change in 17 (89.5%) patients and improvement in two (10.5%) patients.
  
  
  CONCLUSIONS
  Although the efficacy of coil embolization of anterior communicating artery aneurysms is unquestionable and the procedure-related complications are acceptable, they should not be neglected. Further investigations are needed to better understand protective factors, as well as to establish unequivocally appropriate management strategy of these complications.
authors.affiliation: Medical University of Silesia, School of Medicine in Katowice, Department of Neurosurgery, Poland damkocur@gmail.com.
authors.forename: Damian
authors.initials: D
authors.lastname: Kocur
authors.affiliation: Medical University of Silesia, School of Medicine in Katowice, Department of Radiology and Nuclear Medicine, Poland.
authors.forename: Miłosz
authors.initials: M
authors.lastname: Zbroszczyk
authors.affiliation: Medical University of Silesia, School of Medicine in Katowice, Department of Neurosurgery, Poland.
authors.forename: Nikodem
authors.initials: N
authors.lastname: Przybyłko
authors.affiliation: Medical University of Silesia, School of Medicine in Katowice, Department of Neurosurgery, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Hofman
authors.affiliation: Medical University of Silesia, School of Medicine in Katowice, Department of Neurosurgery, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Jamróz
authors.affiliation: Medical University of Silesia, School of Medicine in Katowice, Department of Radiology and Nuclear Medicine, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Baron
authors.affiliation: Medical University of Silesia, School of Medicine in Katowice, Department of Neurosurgery, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Bażowski
authors.affiliation: Medical University of Silesia, School of Medicine in Katowice, Department of Neurosurgery, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Kwiek
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D001807:Blood Vessel Prosthesis; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Anterior communicating artery; aneurysm; embolization