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Case Allocation in the Management of Ruptured Anterior Communicating Aneurysm Using Endovascular Embolization as a First Option Ken KAZUMATA 1 , Satoshi USHIKOSHI 1 , Shunsuke TERASAKA 2 , Jurou SAKURAI 1 , Osamu KIKUCHI 1 , Yuka YOKOYAMA 1 , Katuyuki ASAOKA 1 , Kouji ITAMOTO 1 , Katsuhiko MARUICHI 1 1Department of Neurosurgery,Teine Keijinkai Hospital 2Department of Neurosurgery,Hokkaido University School of Medicine Keyword: cerebral aneurysm , subarachnoid hemorrhage , intravascular surgery , microsurgery , anterior communicating aneurysm pp.553-558
Published Date 2009/6/10
DOI https://doi.org/10.11477/mf.1436100955
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 Objective: The management of ruptured anterior communicating aneurysms remains controversial since the results of ISAT have been reported. The aim of our study is to report our decision-making process and outcome in 36 consecutive cases using endovascular coil embolization as a first choice of treatment.

 Patients and methods: Thirty-six patients were studied. Since April, 2004, the treatment modality has been decided after discussion between the endovascular and cerebrovascular surgeons, taking into account the physiological status, treatment risk and morphology of the aneurysm.

 Results: Twelve (33%) of 36 patients were allocated to coil embolization. Factors leading to the selection of clipping surgery were decided mostly by the morphology of the aneurysm, namely, tiny in 11 (47.8%), irregular shape in 6 (26.1%), broad neck in 3 (13.0%) and bleb located at the neck in 3 (13.0%). Half of the aneurysms projecting anteriorly were treated by coil embolization.

 Conclusion: The allocation rate of endovascular treatment in ruptured anterior communicating aneurysms was 33%. Endovascular treatment was effective in at least half of the anterior the projecting aneurysms.


Copyright © 2009, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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