• World Neurosurg · Nov 2018

    Microsurgical Treatment of Unruptured Anterior Choroidal Artery Aneurysms: Incidence of and Risk Factors for Procedure-Related Complications.

    • Chang Ki Jang, Keun Young Park, Jae Whan Lee, Seung Kon Huh, Jung Hoon Kim, Sunghan Kim, and Joonho Chung.
    • Department of Neurosurgery, Severance Hospital, Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
    • World Neurosurg. 2018 Nov 1; 119: e679-e685.

    ObjectiveTo describe our experiences with microsurgical treatment of unruptured anterior choroidal artery (AchA) aneurysms, and to evaluate the incidence of and risk factors for procedure-related complications.MethodsThe study included 110 patients treated between January 2012 and December 2016. All patients met the following criteria: 1) microsurgical treatment of an unruptured AchA aneurysm was performed; and 2) clinical and radiographic follow-up data were available, including findings from preoperative digital subtraction angiography. The incidence of and risk factors for procedure-related complications were retrospectively evaluated. The χ2 test and Mann-Whitney U test were used in statistical analysis, and univariate analysis and multivariate logistic regression analysis were conducted.ResultsProcedure-related complications occurred in 5 patients (4.5%), including symptomatic complications in 4 patients (3.6%) and asymptomatic complications in 1 patient (0.9%). Multivariate logistic regression analysis indicated that the angle between the vertical line to the cranial base and the axis of the communicating segment of the internal carotid artery (MiC angle) (odds ratio [OR], 1.66; 95% confidence interval [CI], 1.13-5.26; P = 0.038) and the angle between the projection line of the aneurysmal dome and the axis of the communicating segment of the internal carotid artery (DC angle) (OR, 3.82; 95% CI, 1.49-11.7; P = 0.014) were independent risk factors for procedure-related complications.ConclusionsWhen microsurgical treatment of unruptured AchA aneurysms was performed, the procedure-related complication rate was 4.5%. Patients with AchA aneurysms with a smaller MiC angle and smaller DC angle may be at a higher risk of procedure-related complications when undergoing microsurgical treatment.Copyright © 2018 Elsevier Inc. All rights reserved.

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