Article Figures & Data
Figures
- Fig 1.
Images of a 63-year-old woman who presented with subarachnoid hemorrhage. A, 3D volume-rendering image in oblique projection reveals an anterior choroidal artery aneurysm with daughter sac. The anterior choroidal artery is incorporated into the aneurysm neck. B, Unsubtracted image in working-projection obtained during the procedure. The aneurysm is treated with the double-catheter technique. Note 2 radiopaque markers of the tip of the microcatheter near the aneurysm neck. C, Postembolization control angiography in working-projection reveals near complete occlusion of the aneurysm sac.
- Fig 2.
Images of a 46-year-old man who presented with subarachnoid hemorrhage. A, 3D volume-rendering image reveals anterior choroidal artery aneurysm with the daughter sac. B, The anterior choroidal artery is well preserved on follow-up angiography performed due to the postoperative contralateral hemiparesis. C, Follow-up CT reveals low attenuation in the ipsilateral anterior choroidal artery territory, posterior limb of right internal capsule.
Tables
Variable Coil Clip P No. of patients (aneurysms) 37 (38) 35 (35) Mean age ± SE (range), y 54 ± 13 (23–78) 45 ± 12 (25–63) .005 Sex,n (%) NS Male 14 (37.8) 15 (42.9) Female 23 (62.2) 20 (57.1) No. of aneurysms 38* 35 Size of aneurysm, mean ± SE (range), mm 6.6 ± 3.7 (2.8–18) 5.8 ± 2.1 (3.0–12.2) NS Diameter of aneurysm neck (range), mm 3.2 ± 1.8 (1.4–10) 3.2 ± 1.0 (2–6) NS Presentations, n (%) NS SAH from AchoA aneurysms 23 (60.5) 30 (85.7) SAH from other aneurysms 5 (13.2) Third-nerve palsy 3 (7.9) Third-nerve palsy after AchoA territory infarction 1 (2.6) Incidental 6 (15.8) 5 (14.3) Hunt and Hess grade, n (%) NS No SAH 10 (27.0) 5 (14.3) 1–3 20 (54.1) 27 (77.2) 4 or 5 7 (18.9) 3 (8.1) Note:—NS indicates not significant; AchoA, anterior choroidal artery; SAH, subarachnoid hemorrhage.
* One patient had bilateral AchoA aneurysms.
mRS HH 0 (No SAH), n (%) HH 1–3, n (%) HH 4 or 5, n (%) Total, n (%) Coil Clip Coil Clip Coil Clip Coil Clip 0–3 10 (100) 5 (100) 20 (100) 25 (92.6) 1 (14.3) 1 (33.3) 31 (83.8) 31 (88.6) 4 or 5 0 (0) 0 (0) 0 (0) 2 (7.4)* 4 (57.1) 0 (0) 4 (10.8) 2 (5.7) 6 0 (0) 0 (0) 0 (0) 0 (0) 2 (28.6) 2 (66.7) 2 (5.4) 2 (5.7) Total 10 (100) 5 (100) 20 (100) 27 (100) 7 (100) 3 (100) 37 (100) 35 (100) Note:—mRS indicates modified Rankin scale score; HH, Hunt and Hess grade; SAH, subarachnoid hemorrhage.
* Both patients had treatment-related anterior choroidal artery infarctions to result in permanent grade 2 contralateral hemiparesis.
Variable Category Odds Ratio 95% Confidence Interval P Age <65 2.375 0.407 13.848 .300 ≥65 Sex Male 3.000 0.589 15.279 .153 Female Aneurysm size ≤7 mm 0.389 0.045 3.337 .341 >7 mm Neck type Narrow* 2.271 0.501 10.302 .248 Wide Presence of SAH No 1.208 1.074 1.359 .084 Yes HH 0–3 46.667 7.858 277.145 .000 4 to 5 AchoA infarction Yes 7.625 0.939 61.891 .088 No Treatment modality Coil 0.688 0.177 2.676 .422 Clip Note:—AchoA indicates anterior choroidal artery; HH, Hunt and Hess grade; SAH, subarachnoid hemorrhage.
* Narrow neck includes a dome-to-neck ratio >0.85 and neck diameter <4 mm.
- Table 4:
Multivariable logistic regression analysis modeling poor outcome (modified Rankin scale score ≤4)
Variable Categories Odds Radio 95% Confidence Interval P Sex Male 6.056 0.639 5557.420 .117 Female Presence of SAH Yes 944.538 0.000 4331.254 .870 No Hunt and Hess grade 0–3 111.009 8.692 1417.774 .000 4 or 5 Treatment-related AchoA infarction No 60.918 2.900 1279.810 .008 Yes Note:—AchoA indicates anterior choroidal artery; HH, Hunt and Hess grade; SAH, subarachnoid hemorrhage.
Complications Coil Group, n (%) Clip Group P AchoA infarction 0 of 37 (0) 4 of 35 (11.4) .048 Third-nerve palsy 0 of 37 (0) 1 of 35 (2.9) NS Note:—AchoA indicates anterior choroidal artery; NS, not significant.
