Endovascular treatment of anterior choroidal artery aneurysms

BACKGROUND AND PURPOSE: Ischemic stroke is the most common complication after surgical clipping of anterior choroidal artery (AChA) aneurysms, and the reported morbidity-mortality rates vary from 5% to 50%. We report the findings in a series of 18 consecutive patients who underwent endovascular treatment (EVT) for an AChA berry aneurysm. METHODS: In this retrospective study, the aneurysms were defined according to their size and position, the presence of a concomitant arteriovenous malformation (AVM), the mode of presentation. The patients were clinically assessed before and after the EVT, as well as at each angiographic follow-up. RESULTS: All were small-sized aneurysms, with greater diameters ranging from 2 to 8 mm (mean, 4 mm), arising from the supraclinoid internal carotid artery close to the origin of the AChA. Two were AVM-associated aneurysms. Fourteen patients (14/18 [78%]) presented with subarachnoid hemorrhage. All aneurysms were selectively embolized with coils. There was one (1/18 [5.5%]) treatment-related death due to aneurysm perforation. Another patient (1/18 [5.5%]) developed a transient controlateral hemiparesis. Fourteen patients (14/18 [78%]) were followed up clinically and angiographically for 3-32 months (mean, 14 months). None of them (re)hemorrhaged during this period. CONCLUSION: The EVT of AChA berry aneurysms is effective to protect from rebleeding. Our complication rate compares favorably with those of the surgical series.