Endovascular Management of Anterior Communicating Artery Aneurysms: A Prospective Study

Abstract

Background: Intracranial aneurysms are life threatening and disabling vascular lesions. The majority of aneurysms are located at branching points along the proximal arterial tree, suggesting that haemodynamic factors play significant role in aneurysms formation. Aim: The aim of the work was to evaluate the efficacy, safety, clinical and radiological outcome of endovascular management of anterior communicating artery aneurysms. Patients and Methods: This study was a prospective study conducted on 20 patients with anterior communicating artery aneurysms at Neurosurgery Departments – Tanta University hospitals between February 2021 and April 2022. Results: Successful Endovascular treatment was achieved in 19 patients. 17 patients had good recovery (Glasgo outcome scale 5), 1 patient had moderate disability (GOS 4), no patients severely disabled (GOS 3), and 1 patient died (GOS 1). According to hunt and hess grading (5 patients before EVT), 10 patients with grade 1, 5 patients with grade 2 and 5 patients with grade 3 and all patients were with the same grading after ETV without deterioration. Conclusion: In this thesis, EVT was an effective and safe technique for treatment without any treatment related morbidity or mortality. Despite our good angiographic and clinical outcome either postoperatively or during early follow up period, still longer angiographic and clinical follow up is mandatory in all cases since initial total obliteration is not a guarantee for permanent obliteration.