Article Figures & Data
Figures
- Fig 1.
A middle-aged patient presenting with a ruptured bilobed aneurysm of the anterior communicating artery (measuring 6.8 × 4.8 mm), treated using balloon-assisted coiling via TRA. A, The right ICA was catheterized with a guide catheter via right TRA. B, An angiogram of the right ICA highlights the anterior communicating artery aneurysm. C, An angiogram of the right ICA, with a dual-lumen balloon and microcatheter in place. D, An angiogram of the right ICA shows the total occlusion of the aneurysm.
- Fig 2.
A middle-aged patient presenting with a ruptured aneurysm of the anterior communicating artery (measuring 7 × 4 mm), treated using coiling via left TRA. A, The right common carotid artery was catheterized using a Simmons shaped catheter via left TRA; then, a guiding catheter (B) was advanced over it. C, An angiogram of the right ICA highlights the irregular aneurysm of the anterior communicating artery. D, An angiogram of the right ICA shows the total occlusion of the aneurysm.
Tables
Ruptured (n = 33) Unruptured (n = 29) Age (mean) (range) (yr) 52.6 (31–79) 54.5 (37–77) Female 16 16 BMI (mean) 27.4 27.5 Arterial hypertension 17 (51.5%) 18 (62%) Current smoking 22 (66.6%) 17 (58.6%) Diabetes mellitus 2 (6%) 3 (10.3%) Alcohol abuse 6 (18.1%) 2 (6.8%) Dyslipidemia 5 (15.5%) 9 (31%) Family history of aneurysm 2 (6%) 2 (6.8%) Antithrombotic medications 2 (6%) 12 (41.3%) WFNS score I 13 (39.3%) II 10 (30.3%) III 1 (3%) IV 3 (9%) V 6 (18.1%) Fisher scale 1 1 (3%) 2 2 (6%) 3 13 (39.3%) 4 16 (48.4%) Hydrocephalus 10 (30.3%) Aneurysm site AcomA 17 (51.5%) 13 (44.8%) PcomA 2 (6%) 4 (13.7%) Paraclinoid 2 (6%) 3 (10.3%) PICA 1 (3%) 1 (3.4%) Tip of the basilar artery 1 (3%) 5 (17.2%) Terminus of the carotid artery 0 (0%) 1 (3.4%) Pericallosal artery 2 (6%) 0 (0%) Middle cerebral artery bifurcation 8 (24.2%) 2 (6.8%) Aneurysm length (mean) (range) (mm) 7 (2.5–12) 7.4 (4–28) Note:—BMI indicates body mass index; WFNS, World Federation of Neurologic Societies; AcomA, anterior communicating artery; PcomA, posterior communicating artery.
Ruptured (n = 33) Unruptured (n = 31) TRA side Right 26 (78.7%) 26 (83.8%) Left 7 (21.2%) 5 (16.1%) Aneurysm side Right 16 (48.4%) 15 (48.4%) Left 17 (51.5%) 16 (51.6%) Crossover 2 (3.1%) 0 (0%) Embolization technique Coiling 21 (63.6%) 13 (41.9%) Balloon-assisted technique 12 (36.4%) 10 (32.2%) Stent-assisted technique 0 (0%) 6 (19.3%) Flow diverter 0 (0%) 2 (6.4%) Intraoperative thromboembolic complications 2 (6%) 2 (6.4%) Intraoperative rupture 1 (3%) 0 (0%) Snelling et al14 Chen et al15 Goland et al16 Chivot et al n 33 49 40 64 Type of treatment Flow diverter 11 49 5 2 Coils 12 0 35 34 Balloon-assisted coiling 3 0 0 22 Stent-assisted coiling 6 0 0 6 Vessel sacrifice 1 0 0 0 Permanent neurologic complications 0 0 0 0 Crossover 15.1% (5/33) 20.40% (10/49) 0 3.1% (2/64) Failure reasons Radial artery spasm 2 2 0 0 LICA tortuosity 0 4 0 0 LCCA origin angle 2 4 0 1 Subclavian tortuosity 1 0 0 0 Subclavian occlusion 0 0 0 1 Note:—LICA indicates left internal carotid artery; LCCA, left common carotid artery.
