Coiling for an unruptured saccular aneurysm at the non-branching segment of the distal anterior cerebral artery: Case report and literature review

Abstract

Background Saccular aneurysms in the non-branching segment of the distal anterior cerebral artery (DACA) are extremely rare. Here, we describe the first case of coil embolization using a simple, non-adjunctive technique for an aneurysm at this rare location. Case description A 74-year-old man with an asymptomatic, unruptured aneurysm of the right DACA was followed up annually for 3 years by medical checkup. Endovascular treatment was proposed because of a slight angiographic change in the shape of the aneurysm in the past year. The aneurysm at the non-branching site of the right calloso-marginal artery was 2 mm distal to the origin, and measured 3 mm in height and 3.3 mm in width, with a neck measuring 1.7 mm wide; the calloso-marginal artery diameter was 1.6 mm. The aneurysm was successfully embolized with a simple technique using a Pre-Shaped S Microcatheter and two coils. Conclusions The simple, non-adjunctive technique for coil embolization of saccular side-wall type aneurysm in the non-branching segment of the DACA could be performed using the appropriate catheter and a softer coil.

A complete thrombotic large aneurysm at the nonbranching segment of the distal anterior cerebral artery mimicking a cavernous malformation: illustrative case

“…Aneurysms at the distal ACA account for approximately 1%-9% of intracranial aneurysms and most commonly occur at the bifurcation of the pericallosal and calloso-marginal arteries. [4][5][6][7] Saccular aneurysms at the nonbranching segment of the distal ACA are extremely rare, 1 and pseudoaneurysms, which are mostly traumatic or infectious, at this site are also relatively rare. 8,9 However, as the patient had no history of infection or trauma, the cause and mechanism of the aneurysmal origin were unknown.…”

“…Saccular aneurysms of the nonbranching segment of the distal anterior cerebral artery (ACA) are extremely rare. 1 Moreover, thrombotic aneurysms at this segment are even more rare. Thrombotic aneurysms are occasionally difficult to differentiate from cavernous malformations, intracranial hematomas, or brain tumors by radiographic features alone.…”