Department of Radiology, Keimyung University Dongsan Medical Center, Daegu, South Korea.
Acta Neurochir (Wien). 2011 Feb;153(2):279-85. doi: 10.1007/s00701-010-0804-5. Epub 2010 Sep 26.
There have been few reports on the endovascular treatment of aneurysms arising from A1 due to their rarity. We report the angiographic results, clinical outcomes, and technical aspects of endovascular treatment for 13 A1 aneurysms in 12 patients.
From January 2002 to November 2007, 12 patients (9 females and 3 males) with 13 A1 aneurysms underwent endovascular treatment. Three of these patients presented with subarachnoid hemorrhage, and 10 unruptured aneurysms were detected in 9 patients. All of the aneurysms were successfully treated with coil embolization. Most of the aneurysms projected posteriorly (61.5%) and were located in the proximal A1 segment (69.2%). Procedural, clinical, and radiological follow-up data were reviewed.
Procedure-related complications occurred in 3 patients (25%) and included 1 non-leaking aneurysmal perforation and 2 thromboembolic events; none of them were clinically significant. No bleeding or rebleeding occurred during the follow-up period in this cohort of patients.
Endovascular coil embolization is an effective treatment modality for A1 aneurysms. Tailored microcatheter shaping according to aneurysm projection and location is necessary. Long-term follow-up studies involving a larger number of patients and further comparisons with surgical data are needed.
由于 A1 段动脉瘤很少见，因此有关其血管内治疗的报道很少。我们报告了 12 例 13 个 A1 段动脉瘤患者的血管内治疗的血管造影结果、临床结果和技术方面。
2002 年 1 月至 2007 年 11 月，12 例患者（9 例女性，3 例男性）有 13 个 A1 段动脉瘤接受了血管内治疗。其中 3 例患者有蛛网膜下腔出血，9 例患者中发现了 10 个未破裂的动脉瘤。所有的动脉瘤都成功地用弹簧圈栓塞治疗。大多数动脉瘤呈向后突出（61.5%），位于 A1 段近端（69.2%）。回顾了治疗过程、临床和放射学随访数据。
3 例患者（25%）出现与操作相关的并发症，包括 1 例非漏动脉瘤穿孔和 2 例血栓栓塞事件；但均无临床意义。在本队列患者的随访期间，没有出血或再出血。
血管内弹簧圈栓塞是 A1 段动脉瘤的有效治疗方法。根据动脉瘤的突出部位和位置，需要定制微导管的形状。需要进行长期的随访研究，包括更多的患者，并与手术数据进行进一步的比较。
