PT  - JOURNAL ARTICLE
AU  - Kim, B.M.
AU  - Kim, D.I.
AU  - Shin, Y.S.
AU  - Chung, E.C.
AU  - Kim, D.J.
AU  - Suh, S.H.
AU  - Kim, S.Y.
AU  - Park, S.I.
AU  - Choi, C.S.
AU  - Won, Y.S.
TI  - Clinical Outcome and Ischemic Complication after Treatment of Anterior Choroidal Artery Aneurysm: Comparison between Surgical Clipping and Endovascular Coiling
AID  - 10.3174/ajnr.A0806
DP  - 2008 Feb 01
TA  - American Journal of Neuroradiology
PG  - 286--290
VI  - 29
IP  - 2
4099  - http://www.ajnr.org/content/29/2/286.short
4100  - http://www.ajnr.org/content/29/2/286.full
SO  - Am. J. Neuroradiol.2008 Feb 01; 29
AB  - BACKGROUND AND PURPOSE: Although coiling has been favorably comparable with clipping for treatment of most intracranial aneurysms, there is a controversy on which modality is safer for anterior choroidal artery (AchoA) aneurysm. We retrospectively evaluated the clinical outcomes and treatment-related complications after surgical clipping and endovascular coiling of AchoA aneurysms.MATERIALS AND METHODS: Seventy-three AchoA aneurysms were recruited from 1895 intracranial aneurysms, which were treated either by surgical clipping or by endovascular coiling in 4 institutions between May 1999 and December 2006. The AchoA aneurysms were dichotomized according to the modality of treatment, the coil group (37 patients; 38 aneurysms) and the clip group (35 patients; 35 aneurysms). Clinical outcomes and incidence of treatment-related complications between 2 groups and the factors influencing the clinical outcomes were evaluated.RESULTS: There was no rebleeding in both groups during follow-up, for 4–72 months (mean, 27 months) in the coil group and for 3–84 months (mean, 34 months) in the clip group. In the coil group, 31 patients (83.8%) had favorable outcome (modified Rankin Scale score [mRS], 0–3). In the clip group, 31 patients (88.6%) had favorable outcome. The complication of coiling was transient contralateral hemiparesis in 2 patients, who recovered completely. The complications of clipping were permanent contralateral hemiparesis due to AchoA infarction in 4 patients and third-nerve palsy in 1 patient. Hunt and Hess grade 4 or 5 and AchoA infarction were significantly correlated with poor outcome (mRS, ≤4). Clipping had significantly higher incidence of AchoA infarction than coiling (P < .05).CONCLUSION: Coiling of AchoA aneurysms appears comparable with clipping in clinical outcome and prevention of rebleeding, with significantly lower incidence of AchoA infarction than clipping.