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Peruvian Journal of Neurosurgery
Endovascular treatment with coils of aneurysm of the anterior communicating artery, angiographic control, and evolution according to packing density: case series.
GABRIEL PONCE M, OSMAR ORDINOLA C, DANTE VALER G., GIANCARLO SAAL Z., JESÚS FLORES Q., RODOLFO RODRÍGUEZ V.Abstract (Spanish) || Full Text || PDF (Spanish)
Objective: The goal of this study is to present the outcomes of endovascular treatment performed on a group of patients diagnosed with ruptured aneurysms in the anterior communicating artery. The effectiveness of the treatment will be assessed based on the degree of packing observed in both immediate and subsequent angiography control.
Methods: An observational, retrospective, and descriptive study was conducted at the Guillermo Almenara Hospital to analyze the treatment outcomes of patients with ruptured anterior communicating artery aneurysms, who were solely treated through embolization with coils (without stent or balloon) in the year 2021 and 2022. The degree of packing of the aneurysms was measured and analyzed using the AngioCalc program, while data analysis was performed using Excel.
Results: Three patients with ACom aneurysm were successfully treated using only coils for embolization. Among them, two patients had a Fisher IV subarachnoid hemorrhage (SAH) while one patient had a Fisher III SAH. The volume of the aneurysm was 12.78 mm3 for patient A, 51.65 mm3 for patient B, and 34.06 mm3 for patient C. The degree of packing of the aneurysm was calculated using a formula and found to be 23.79%, 28.7%, and 34.06% for patients A, B, and C respectively. These values were all greater than 24%. The immediate angiography results were classified as RR II for patients A and B, and RR IIIA for patient C. Subsequent angiographic control results were classified as RR IIIA for patient A, RR II for patient B, and RR IIIB for patient C. All patients had a favorable outcome.
Conclusions: The degree of coil packing affects the evolution of an embolized aneurysm, therefore serial angiographic monitoring is necessary to detect recurrence and perform additional endovascular treatment if needed.
Keywords: Aneurysm, Ruptured, Subarachnoid Hemorrhage, Angiography, Embolization, Therapeutic. (Source: MeSH NLM)