Skip to main content
Top
Published in: Clinical Neuroradiology 3/2018

01-09-2018 | Original Article

Complication Risk Factors in Anterior Choroidal Artery Aneurysm Treatment

Authors: Arthur André, Anne-Laure Boch, Federico Di Maria, Aurélien Nouet, Nader Sourour, Stéphane Clémenceau, Joseph Gabrieli, Vincent Degos, Chiheb Zeghal, Jacques Chiras, Philippe Cornu, Frédéric Clarençon

Published in: Clinical Neuroradiology | Issue 3/2018

Login to get access

Abstract

Object

The anterior choroidal artery (AChoA) is a rare location for intracranial aneurysms. The treatment of these aneurysms may be challenging due to the risk of occlusion of such a small and eloquent artery as the AChoA. We aimed to evaluate the risk factors for complications in AChoA aneurysm treatment.

Methods

We retrospectively analyzed 47 consecutive AChoA aneurysms in 40 patients treated in our institution from 1999 and 2014 by endovascular means (87%) or surgical clipping (13%). Minor (transient or minor neurological deficits) and major complications (severe permanent neurological deficits or death) were systematically recorded. The influence of patient age, sex, aneurysm size, neck size, shape, dome-to-neck ratio and treatment technique on the occurrence of procedure-related complications was evaluated.

Results

Of the patients 11 experienced procedure-related complications (5 major, 6 minor). Aneurysms with multilobed shape were significantly associated with a higher procedure-related complication rate. There was a tendency for higher major procedure-related complication rate in small volume aneurysms. We did not find any association between the other factors analyzed and occurrence of procedure-related complications.

Conclusion

Treatment of AChoA aneurysms has an acceptable complication risk. We did not find any significant differences between surgical and endovascular treatment in terms of procedure-related complication rates. Multilobed aneurysms were significantly associated with a higher procedure-related complication rate.
Literature
1.
go back to reference Locksley HB, Sahs AL, Sandler R. Report on the cooperative study of intracranial aneurysms and subarachnoid hemorrhage. 3. Subarachnoid hemorrhage unrelated to intracranial aneurysm and A‑V malformation. A study of associated diseases and prognosis. J Neurosurg. 1966;24(6):1034–56.CrossRefPubMed Locksley HB, Sahs AL, Sandler R. Report on the cooperative study of intracranial aneurysms and subarachnoid hemorrhage. 3. Subarachnoid hemorrhage unrelated to intracranial aneurysm and A‑V malformation. A study of associated diseases and prognosis. J Neurosurg. 1966;24(6):1034–56.CrossRefPubMed
2.
go back to reference Brilstra EH, Rinkel GJ, van der Graaf Y, van Rooij WJ, Algra A. Treatment of intracranial aneurysms by embolization with coils: a systematic review. Stroke. 1999;30(2):470–6.CrossRefPubMed Brilstra EH, Rinkel GJ, van der Graaf Y, van Rooij WJ, Algra A. Treatment of intracranial aneurysms by embolization with coils: a systematic review. Stroke. 1999;30(2):470–6.CrossRefPubMed
3.
go back to reference Rangel-Castilla L, Munich SA, Jaleel N, Cress MC, Krishna C, Sonig A, Snyder KV, Siddiqui AH, Levy EI. Patency of anterior circulation branch vessels after pipeline embolization: longer-term results from 82 aneurysm cases. J Neurosurg. 2016 Jun 10:1–6. [Epub ahead of print] Rangel-Castilla L, Munich SA, Jaleel N, Cress MC, Krishna C, Sonig A, Snyder KV, Siddiqui AH, Levy EI. Patency of anterior circulation branch vessels after pipeline embolization: longer-term results from 82 aneurysm cases. J Neurosurg. 2016 Jun 10:1–6. [Epub ahead of print]
4.
go back to reference Yaşargil MG, Yonas H, Gasser JC. Anterior choroidal artery aneurysms: their anatomy and surgical significance. Surg Neurol. 1978;9(2):129–38.PubMed Yaşargil MG, Yonas H, Gasser JC. Anterior choroidal artery aneurysms: their anatomy and surgical significance. Surg Neurol. 1978;9(2):129–38.PubMed
5.
go back to reference Banks JL, Marotta CA. Outcomes validity and reliability of the modified Rankin scale: implications for stroke clinical trials: a literature review and synthesis. Stroke. 2007;38(3):1091–6.CrossRefPubMed Banks JL, Marotta CA. Outcomes validity and reliability of the modified Rankin scale: implications for stroke clinical trials: a literature review and synthesis. Stroke. 2007;38(3):1091–6.CrossRefPubMed
6.
go back to reference Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke. 2001;32(9):1998–2004.CrossRefPubMed Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke. 2001;32(9):1998–2004.CrossRefPubMed
7.
go back to reference Drake CG, Vanderlinden RG, Amacher AL. Carotid-choroidal aneurysms. J Neurosurg. 1968;29(1):32–6.CrossRefPubMed Drake CG, Vanderlinden RG, Amacher AL. Carotid-choroidal aneurysms. J Neurosurg. 1968;29(1):32–6.CrossRefPubMed
8.
go back to reference Perria L, Viale GL, Rivano C. Aneurysms of the junction internal carotid artery and anterior choroid artery. Acta Neurochir (Wien). 1969;21(2):153–66.CrossRef Perria L, Viale GL, Rivano C. Aneurysms of the junction internal carotid artery and anterior choroid artery. Acta Neurochir (Wien). 1969;21(2):153–66.CrossRef
9.
go back to reference Friedman JA, Pichelmann MA, Piepgras DG, Atkinson JL, Maher CO, Meyer FB, Hansen KK. Ischemic complications of surgery for anterior choroidal artery aneurysms. J Neurosurg. 2001;94(4):565–72.CrossRefPubMed Friedman JA, Pichelmann MA, Piepgras DG, Atkinson JL, Maher CO, Meyer FB, Hansen KK. Ischemic complications of surgery for anterior choroidal artery aneurysms. J Neurosurg. 2001;94(4):565–72.CrossRefPubMed
10.
go back to reference Furtado SV, Venkatesh PK, Hegde AS. Neurological complications and surgical outcome in patients with anterior choroidal segment aneurysms. Int J Neurosci. 2010;120(4):291–7.CrossRefPubMed Furtado SV, Venkatesh PK, Hegde AS. Neurological complications and surgical outcome in patients with anterior choroidal segment aneurysms. Int J Neurosci. 2010;120(4):291–7.CrossRefPubMed
11.
go back to reference Lehecka M, Dashti R, Laakso A, van Popta JS, Romani R, Navratil O, Kivipelto L, Kivisaari R, Foroughi M, Kokuzawa J, Lehto H, Niemelä M, Rinne J, Ronkainen A, Koivisto T, Jääskelainen JE, Hernesniemi J. Microneurosurgical management of anterior choroid artery aneurysms. World Neurosurg. 2010;73(5):486–99.CrossRefPubMed Lehecka M, Dashti R, Laakso A, van Popta JS, Romani R, Navratil O, Kivipelto L, Kivisaari R, Foroughi M, Kokuzawa J, Lehto H, Niemelä M, Rinne J, Ronkainen A, Koivisto T, Jääskelainen JE, Hernesniemi J. Microneurosurgical management of anterior choroid artery aneurysms. World Neurosurg. 2010;73(5):486–99.CrossRefPubMed
12.
go back to reference Shibata Y, Fujita S, Kawaguchi T, Hosoda K, Komatsu H, Tamaki N. Use of microvascular Doppler sonography in aneurysm surgery on the anterior choroidal artery. Neurol Med Chir (Tokyo). 2000;40(1):30–5, discussion 35–7.CrossRef Shibata Y, Fujita S, Kawaguchi T, Hosoda K, Komatsu H, Tamaki N. Use of microvascular Doppler sonography in aneurysm surgery on the anterior choroidal artery. Neurol Med Chir (Tokyo). 2000;40(1):30–5, discussion 35–7.CrossRef
13.
go back to reference Li J, Mukherjee R, Lan Z, Liu Y, He M. Microneurosurgical management of anterior choroidal artery aneurysms: a 16-year institutional experience of 102 patients. Neurol Res. 2012;34(3):272–80.CrossRefPubMed Li J, Mukherjee R, Lan Z, Liu Y, He M. Microneurosurgical management of anterior choroidal artery aneurysms: a 16-year institutional experience of 102 patients. Neurol Res. 2012;34(3):272–80.CrossRefPubMed
14.
go back to reference Lee YS, Park J. Anterior choroidal artery aneurysm surgery: ischemic complications and clinical outcomes revisited. J Korean Neurosurg Soc. 2013;54(2):86–92.CrossRefPubMedPubMedCentral Lee YS, Park J. Anterior choroidal artery aneurysm surgery: ischemic complications and clinical outcomes revisited. J Korean Neurosurg Soc. 2013;54(2):86–92.CrossRefPubMedPubMedCentral
15.
go back to reference Piotin M, Mounayer C, Spelle L, Williams MT, Moret J. Endovascular treatment of anterior choroidal artery aneurysms. AJNR Am J Neuroradiol. 2004;25(2):314–8.PubMed Piotin M, Mounayer C, Spelle L, Williams MT, Moret J. Endovascular treatment of anterior choroidal artery aneurysms. AJNR Am J Neuroradiol. 2004;25(2):314–8.PubMed
16.
go back to reference Kang HS, Kwon BJ, Kwon OK, Jung C, Kim JE, Oh CW, Han MH. Endovascular coil embolization of anterior choroidal artery aneurysms. J Neurosurg. 2009;111(5):963–9.CrossRefPubMed Kang HS, Kwon BJ, Kwon OK, Jung C, Kim JE, Oh CW, Han MH. Endovascular coil embolization of anterior choroidal artery aneurysms. J Neurosurg. 2009;111(5):963–9.CrossRefPubMed
17.
go back to reference Senturk C, Bandeira A, Bruneau M, Dewindt A, Balériaux D, De Witte O, Lubicz B. Endovascular treatment of anterior choroidal artery aneurysms. J Neuroradiol. 2009;36(4):228–32.CrossRefPubMed Senturk C, Bandeira A, Bruneau M, Dewindt A, Balériaux D, De Witte O, Lubicz B. Endovascular treatment of anterior choroidal artery aneurysms. J Neuroradiol. 2009;36(4):228–32.CrossRefPubMed
18.
go back to reference Bohnstedt BN, Kemp WJ 3rd, Li Y, Payner TD, Horner TG, Leipzig TJ, Cohen-Gadol AA. Surgical treatment of 127 anterior choroidal artery aneurysms: a cohort study of resultant ischemic complications. Neurosurgery. 2013;73(6):933–40.CrossRefPubMed Bohnstedt BN, Kemp WJ 3rd, Li Y, Payner TD, Horner TG, Leipzig TJ, Cohen-Gadol AA. Surgical treatment of 127 anterior choroidal artery aneurysms: a cohort study of resultant ischemic complications. Neurosurgery. 2013;73(6):933–40.CrossRefPubMed
19.
go back to reference Kim BM, Kim DI, Shin YS, Chung EC, Kim DJ, Suh SH, Kim SY, Park SI, Choi CS, Won YS. Clinical outcome and ischemic complication after treatment of anterior choroidal artery aneurysm: comparison between surgical clipping and endovascular coiling. AJNR Am J Neuroradiol. 2008;29(2):286–90.CrossRefPubMed Kim BM, Kim DI, Shin YS, Chung EC, Kim DJ, Suh SH, Kim SY, Park SI, Choi CS, Won YS. Clinical outcome and ischemic complication after treatment of anterior choroidal artery aneurysm: comparison between surgical clipping and endovascular coiling. AJNR Am J Neuroradiol. 2008;29(2):286–90.CrossRefPubMed
20.
go back to reference Djamshidian A, Friedman JH. Anxiety and depression in Parkinson’s disease. Curr Treat Options Neurol. 2014;16(4):285.CrossRefPubMed Djamshidian A, Friedman JH. Anxiety and depression in Parkinson’s disease. Curr Treat Options Neurol. 2014;16(4):285.CrossRefPubMed
21.
go back to reference Cho MS, Kim MS, Chang CH, Kim SW, Kim SH, Choi BY. Analysis of clip-induced ischemic complication of anterior choroidal artery aneurysms. J Korean Neurosurg Soc. 2008;43(3):131–4.CrossRefPubMedPubMedCentral Cho MS, Kim MS, Chang CH, Kim SW, Kim SH, Choi BY. Analysis of clip-induced ischemic complication of anterior choroidal artery aneurysms. J Korean Neurosurg Soc. 2008;43(3):131–4.CrossRefPubMedPubMedCentral
22.
go back to reference Suzuki K, Kodama N, Sasaki T, Matsumoto M, Konno Y, Sakuma J, Oinuma M, Murakawa M. Intraoperative monitoring of blood flow insufficiency in the anterior choroidal artery during aneurysm surgery. J Neurosurg. 2003;98(3):507–14.CrossRefPubMed Suzuki K, Kodama N, Sasaki T, Matsumoto M, Konno Y, Sakuma J, Oinuma M, Murakawa M. Intraoperative monitoring of blood flow insufficiency in the anterior choroidal artery during aneurysm surgery. J Neurosurg. 2003;98(3):507–14.CrossRefPubMed
23.
go back to reference Naggara ON, White PM, Guilbert F, Roy D, Weill A, Raymond J. Endovascular treatment of intracranial unruptured aneurysms: systematic review and meta-analysis of the literature on safety and efficacy. Radiology. 2010;256(3):887–97.CrossRefPubMed Naggara ON, White PM, Guilbert F, Roy D, Weill A, Raymond J. Endovascular treatment of intracranial unruptured aneurysms: systematic review and meta-analysis of the literature on safety and efficacy. Radiology. 2010;256(3):887–97.CrossRefPubMed
24.
go back to reference Kim BM, Kim DI, Chung EC, Kim SY, Shin YS, Park SI, Kim DJ, Suh SH, Choi CS, Won YS. Endovascular coil embolization for anterior choroidal artery aneurysms. Neuroradiology. 2008;50(3):251–7.CrossRefPubMed Kim BM, Kim DI, Chung EC, Kim SY, Shin YS, Park SI, Kim DJ, Suh SH, Choi CS, Won YS. Endovascular coil embolization for anterior choroidal artery aneurysms. Neuroradiology. 2008;50(3):251–7.CrossRefPubMed
25.
go back to reference Suh W, Cho HK, Kee C. Evaluation of peripapillary choroidal thickness in unilateral normal-tension glaucoma. Jpn J Ophthalmol. 2014;58(1):62–7.CrossRefPubMed Suh W, Cho HK, Kee C. Evaluation of peripapillary choroidal thickness in unilateral normal-tension glaucoma. Jpn J Ophthalmol. 2014;58(1):62–7.CrossRefPubMed
26.
go back to reference Morgenstern LB, Hankins LL, Grotta JC. Anterior choroidal artery aneurysm and stroke. Neurology. 1996;47(4):1090–2.CrossRefPubMed Morgenstern LB, Hankins LL, Grotta JC. Anterior choroidal artery aneurysm and stroke. Neurology. 1996;47(4):1090–2.CrossRefPubMed
27.
go back to reference Shapiro M, Babb J, Becske T, Nelson PK. Safety and efficacy of adjunctive balloon remodeling during endovascular treatment of intracranial aneurysms: a literature review. AJNR Am J Neuroradiol. 2008;29(9):1777–81.CrossRefPubMed Shapiro M, Babb J, Becske T, Nelson PK. Safety and efficacy of adjunctive balloon remodeling during endovascular treatment of intracranial aneurysms: a literature review. AJNR Am J Neuroradiol. 2008;29(9):1777–81.CrossRefPubMed
28.
go back to reference Hernesniemi J, Romani R, Niemela M. Skull base and aneurysm surgery. Surg Neurol. 2009;71(1):30–1.CrossRefPubMed Hernesniemi J, Romani R, Niemela M. Skull base and aneurysm surgery. Surg Neurol. 2009;71(1):30–1.CrossRefPubMed
29.
go back to reference Lieber BB, Sadasivan C. Endoluminal scaffolds for vascular reconstruction and exclusion of aneurysms from the cerebral circulation. Stroke. 2010;41(10 Suppl):S21–5. Lieber BB, Sadasivan C. Endoluminal scaffolds for vascular reconstruction and exclusion of aneurysms from the cerebral circulation. Stroke. 2010;41(10 Suppl):S21–5.
30.
go back to reference Lieber BB, Gounis MJ. The physics of endoluminal stenting in the treatment of cerebrovascular aneurysms. Neurol Res. 2002;24(Suppl 1):33–S42.CrossRef Lieber BB, Gounis MJ. The physics of endoluminal stenting in the treatment of cerebrovascular aneurysms. Neurol Res. 2002;24(Suppl 1):33–S42.CrossRef
31.
go back to reference Tremmel M, Xiang J, Natarajan SK, Hopkins LN, Siddiqui AH, Levy EI, Meng H. Alteration of intraaneurysmal hemodynamics for flow diversion using enterprise and vision stents. World Neurosurg. 2010;74(2–3):306–15.CrossRefPubMedPubMedCentral Tremmel M, Xiang J, Natarajan SK, Hopkins LN, Siddiqui AH, Levy EI, Meng H. Alteration of intraaneurysmal hemodynamics for flow diversion using enterprise and vision stents. World Neurosurg. 2010;74(2–3):306–15.CrossRefPubMedPubMedCentral
32.
go back to reference Raz E, Shapiro M, Becske T, Zumofen DW, Tanweer O, Potts MB, Riina HA, Nelson PK. Anterior choroidal artery patency and clinical follow-up after coverage with the pipeline embolization device. AJNR Am J Neuroradiol. 2015;36(5):937–42.CrossRefPubMed Raz E, Shapiro M, Becske T, Zumofen DW, Tanweer O, Potts MB, Riina HA, Nelson PK. Anterior choroidal artery patency and clinical follow-up after coverage with the pipeline embolization device. AJNR Am J Neuroradiol. 2015;36(5):937–42.CrossRefPubMed
33.
go back to reference Brinjikji W, Kallmes DF, Cloft HJ, Lanzino G. Patency of the anterior choroidal artery after flow-diversion treatment of internal carotid artery aneurysms. AJNR Am J Neuroradiol. 2015;36(3):537–41.CrossRefPubMed Brinjikji W, Kallmes DF, Cloft HJ, Lanzino G. Patency of the anterior choroidal artery after flow-diversion treatment of internal carotid artery aneurysms. AJNR Am J Neuroradiol. 2015;36(3):537–41.CrossRefPubMed
34.
go back to reference Raabe A, Nakaji P, Beck J, Kim LJ, Hsu FP, Kamerman JD, Seifert V, Spetzler RF. Prospective evaluation of surgical microscope-integrated intraoperative near-infrared indocyanine green videoangiography during aneurysm surgery. J Neurosurg. 2005;103(6):982–9.CrossRefPubMed Raabe A, Nakaji P, Beck J, Kim LJ, Hsu FP, Kamerman JD, Seifert V, Spetzler RF. Prospective evaluation of surgical microscope-integrated intraoperative near-infrared indocyanine green videoangiography during aneurysm surgery. J Neurosurg. 2005;103(6):982–9.CrossRefPubMed
Metadata
Title
Complication Risk Factors in Anterior Choroidal Artery Aneurysm Treatment
Authors
Arthur André
Anne-Laure Boch
Federico Di Maria
Aurélien Nouet
Nader Sourour
Stéphane Clémenceau
Joseph Gabrieli
Vincent Degos
Chiheb Zeghal
Jacques Chiras
Philippe Cornu
Frédéric Clarençon
Publication date
01-09-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 3/2018
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-017-0575-y

Other articles of this Issue 3/2018

Clinical Neuroradiology 3/2018 Go to the issue