Ruptured Distal Anterior Choroidal Artery Aneurysm Treated with Superselective Provocative Testing and Coil Embolization.

Abstract:

BACKGROUND AND IMPORTANCE:Aneurysms of the anterior choroidal artery are uncommon, and distal anterior choroidal artery aneurysms are even rarer, with only 34 cases reported in the medical literature. These lesions have been most commonly reported in association with moyamoya disease or arteriovenous malformations. Most published experience with these aneurysms involves open surgical approaches. Reports of endovascular treatment have been in patients with lesions distal to the plexal point and have employed vessel occlusion with liquid embolic agents in preference to coil embolization. CLINICAL PRESENTATION:We present a case of a ruptured distal anterior choroidal artery aneurysm located on the cisternal segment of the artery. This lesion was successfully treated with endovascular coil embolization. Additionally, the patient underwent pre-embolization superselective provocative testing with amobarbital to assess the safety of parent vessel occlusion. CONCLUSION:Endovascular coil embolization for distal anterior choroidal artery aneurysms is technically feasible and may be preferable to embolization with liquid embolic agents for lesions proximal to the plexal point. This case illustrates the utility of provocative testing and efficacy of endovascular coil embolization for lesions in this unique location.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Schmalz PGR,Alturki A,Ogilvy CS,Thomas AJ

doi

10.1016/j.wneu.2017.05.176

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

1032.e19-1032.e22

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(17)30891-4

journal_volume

105

pub_type

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