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Clinical outcome and ischemic complication after treatment of anterior choroidal artery aneurysm: comparison between surgical clipping and endovascular coiling

Authors
 B.M. Kim  ;  D.I. Kim  ;  Y.S. Shin  ;  E.C. Chung  ;  D.J. Kim  ;  S.H. Suh  ;  S.Y. Kim  ;  S.I. Park  ;  C.S. Choi  ;  Y.S. Won 
Citation
 AMERICAN JOURNAL OF NEURORADIOLOGY, Vol.29(2) : 286-290, 2008 
Journal Title
 AMERICAN JOURNAL OF NEURORADIOLOGY 
ISSN
 0195-6108 
Issue Date
2008
MeSH
Adult ; Aged ; Brain Ischemia/epidemiology* ; Choroid Plexus* ; Comorbidity ; Female ; Humans ; Incidence ; Intracranial Aneurysm/epidemiology* ; Intracranial Aneurysm/therapy* ; Male ; Middle Aged ; Neurosurgical Procedures/statistics & numerical data* ; Risk Assessment/methods* ; Risk Factors ; Treatment Outcome ; Vascular Surgical Procedures/statistics & numerical data*
Keywords
Adult ; Aged ; Brain Ischemia/epidemiology* ; Choroid Plexus* ; Comorbidity ; Female ; Humans ; Incidence ; Intracranial Aneurysm/epidemiology* ; Intracranial Aneurysm/therapy* ; Male ; Middle Aged ; Neurosurgical Procedures/statistics & numerical data* ; Risk Assessment/methods* ; Risk Factors ; Treatment Outcome ; Vascular Surgical Procedures/statistics & numerical data*
Abstract
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, < or =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.
Files in This Item:
T200800782.pdf Download
DOI
10.3174/ajnr.A0806
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Park, Sung Il(박성일)
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Shin, Yong Sam(신용삼)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107048
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