Endovascular treatment of ruptured lobulated anterior communicating artery aneurysms:A retrospective study of 24 patients  

作　　者：Sheng-Xuan Huang Xun-Ping Ai Ze-Hui Kang Zhi-Yong Chen Ren-Man Li Zu-Chao Wu Feng Zhu 

机构地区：[1]Department of Neurosurgery,Sanming First Hospital Affiliated to Fujian Medical University,Sanming 365000,Fujian Province,China

出　　处：《World Journal of Clinical Cases》2024年第15期2529-2541,共13页世界临床病例杂志

基　　金：Supported by Fujian Province Health Young and Middle-aged Backbone Personnel Training Project,No.2021GGB022;Fujian Medical University Sailing Fund,No.2019QH1262.

摘　　要：BACKGROUND Lobulated intracranial aneurysm is a special type of aneurysm with at least one additional cyst in the neck or body of the aneurysm.Lobulated intracranial aneurysm is a complex aneurysm with complex morphology and structure and weak tumor wall,which is an independent risk factor for rupture and hemorrhage.Lobular aneurysms located in the anterior communicating artery complex account for 36.9%of all intracranial lobular aneurysms.Due to its special anatomical structure,both craniotomy and endovascular treatment are more difficult.Compared with single-capsule aneurysms,craniotomy for lobular intracranial aneurysms has a higher risk and complication rate.AIM To investigate the efficacy and safety of endovascular treatment for ruptured lobulated anterior communicating artery aneurysm(ACoAA).METHODS Patients with ruptured lobulated ACoAA received endovascular treatment in Sanming First Hospital Affiliated to Fujian Medical University from June 2020 to June 2022 were retrospectively included.Their demographic,clinical and imaging characteristics,endovascular treatment methods and follow-up results were collected.RESULTS A total of 24 patients with ruptured lobulated ACoAA were included,including 9 males(37.5%)and 15 females(62.5%).Their age was 56.2±8.9 years old(range 39-74).The time from rupture to endovascular treatment was 10.9±12.5 h.The maximum diameter of the aneurysms was 5.1±1.0 mm and neck width were 3.0±0.7 mm.Nineteen patients(79.2%)were double-lobed and 5(20.8%)were multilobed.Fisher's grade:Grade 2 in 16 cases(66.7%),grade 3 in 6 cases(25%),and grade 4 in 2 cases(8.3%).Hunt-Hess grade:Grade 0-2 in 5 cases(20.8%),grade 3-5 in 19 cases(79.2%).Glasgow Coma Scale score:9-12 in 14 cases(58.3%),13-15 in 10 cases(41.7%).Immediately postprocedural Raymond-Roy grade:grade 1 in 23 cases(95.8%),grade 2 in 1 case(4.2%).Raymond-Roy grade in imaging follow-up for 2 wk to 3 months:grade 1 in 23 cases(95.8%),grade 2 in 1 case(4.2%).Followup for 2 to 12 months showed that 21 patients(87.5%)had good function

关 键 词：Intracranial aneurysm Anterior cerebral artery Endovascular surgery EMBOLISM Treatment outcome 

分 类 号：R714.25[医药卫生—妇产科学]