Endovascular Management of Ruptured Distal Anterior Cerebral Artery (DACA) Aneurysms: A Retrospective Review Study

Husain, Shakir; Andhitara, Yovita; Jena, Somnath Prasad; Padilla, Jorge; Aritonang, Sahat; Letsoin, Igor

doi:10.1016/j.wneu.2017.08.005

Cited by 10 publications

(6 citation statements)

References 25 publications

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“…Furthermore, it was reported that intraprocedural complications during endovascular coiling of ruptured aneurysm more often occur in patients with these aneurysm locations. [17][18][19][20] In our case, there were three aneurysms considered unsuitable for endovascular coiling. Furthermore, in endovascular coiling, we had to treat all the aneurysms to reliably treat the precise rupture site because it was impossible to identify the ruptured aneurysms with the fibrin plug at the rupture point under direct vision.…”

Section: Treatment Strategiesmentioning

confidence: 65%

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One-stage operation with ipsilateral two-piece craniotomies for a case of subarachnoid hemorrhage with multiple intracranial aneurysms

Yoshikawa

Ishikawa

2019

Asian J Neurosurg

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Subarachnoid hemorrhage (SAH) with multiple intracranial aneurysms is common, but the difficulties often arise in determining treatment strategy in the acute phase. We experienced a case of SAH with distal anterior cerebral artery aneurysm coexisting with middle cerebral artery and anterior communicating artery aneurysms, in which it was difficult to identify the precise rupture site preoperatively, and both pterional approach and interhemispheric approach were required in the acute phase of SAH. However, we could treat whole aneurysms in one stage and obtained an excellent outcome using our surgical procedure with ipsilateral frontotemporal and frontal parasagittal craniotomies through a single skin incision.

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Section: Treatment Strategiesmentioning

confidence: 65%

“…Furthermore, it was reported that intraprocedural complications during endovascular coiling of ruptured aneurysm more often occur in patients with these aneurysm locations. [17181920]…”

Section: Discussionmentioning

confidence: 99%

One-stage operation with ipsilateral two-piece craniotomies for a case of subarachnoid hemorrhage with multiple intracranial aneurysms

Yoshikawa

Ishikawa

2019

Asian J Neurosurg

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“… 2 9 10 11 However, treatment paradigm has been gradually shifting to endovascular procedure due to its rapid technological advancement and skill development. 6 12 13 14 15 16 17 18 Whatever treatment we choose for ruptured DACA aneurysms, outcome after intervention is less favorable than outcome of other anterior circulation aneurysms. 1 7 11 The aim of this study is to analyze the data and to determine factors which may influence outcome after surgical clipping of ruptured DACA aneurysms.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting the Outcome after Surgical Clipping of Ruptured Distal Anterior Cerebral Artery (DACA) Aneurysms

Sharma,

Karki,

Joshi

et al. 2023

Asian J Neurosurg

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Objective The purpose of this study is to assess demographic, clinical, and unique morphological characteristics of distal anterior cerebral artery (DACA) aneurysm. The relation of outcome included Glasgow Outcome Scale (GOS) using various independent variables, Hunt and Hess clinical grade (H&H), Miller Fischer grade, intraoperative rupture, and comparison of outcomes at discharge and last follow-up. Methods Demographic data, aneurysm characteristics, and treatment outcomes were evaluated in 28 ruptured DACA aneurysms operated over a period of 13 years. Association between independent variables and dependent variables (GOS) at discharge and at last follow-up (13 years) was analyzed, and the interrelationship between these factors and outcome was evaluated. GOS was used to assess functional outcomes. Results Over a period of 13 years, 500 patients harboring ruptured intracranial aneurysms were surgically clipped, and out of them 28 patients (5.6%) had ruptured DACA aneurysms. In this series, 20 (71.4%) patients had low grade and 8 (28.6%) had high grade H&H. Out of the 28 patients, 19 (67.8%) had good recovery, 6 (21.5%) were severely disabled, and 3 (10.7%) died at the time of discharge. On the last follow-up (13 years), smoking (p-value 0.03) and use of temporary clip (p-value 0.00) were significant predictors for unfavorable outcome. Conclusion The results of our case series show that even with ruptured aneurysm excellent overall outcome after microsurgical clipping can be achieved, even though among cerebral aneurysms, DACA aneurysm is considered to have less favorable outcome. Alcohol consumption and use of temporary clip were the predictors for unfavorable outcome at the time of discharge. On the last follow-up, smoking and use of temporary clip were found to be the risk factors for unfavorable outcome. Although the small sample size of this study is a limitation, smoking and use of temporary clip play an important role on the overall outcome. The aim of this study was to analyze data to determine factors which may influence outcome after surgical clipping of ruptured DACA aneurysms.

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“…While surgical clipping is less expensive than endovascular coiling [10][11], endovascular coiling has exhibited a better safety profile compared to surgical clipping [12][13]. However, IA occlusion rate --a measure of treatment effectiveness --was shown to be lower among patients treated with endovascular coiling than among those treated with surgical clipping, potentially increasing the need for retreatment via recanalization [14][15]. In recent years, different types of endovascular treatments became available, including stent-and balloon-assisted coiling (SAC and BAC) [16][17].…”

Section: Introductionmentioning

confidence: 99%

Perioperative Ischemic Stroke in Unruptured Intracranial Aneurysm Surgical or Endovascular Therapy

Beydoun¹,

Beydoun²,

Zonderman³

et al. 2020

Cureus

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Endovascular Management of Ruptured Distal Anterior Cerebral Artery (DACA) Aneurysms: A Retrospective Review Study

Cited by 10 publications

References 25 publications

One-stage operation with ipsilateral two-piece craniotomies for a case of subarachnoid hemorrhage with multiple intracranial aneurysms

One-stage operation with ipsilateral two-piece craniotomies for a case of subarachnoid hemorrhage with multiple intracranial aneurysms

Factors Affecting the Outcome after Surgical Clipping of Ruptured Distal Anterior Cerebral Artery (DACA) Aneurysms

Perioperative Ischemic Stroke in Unruptured Intracranial Aneurysm Surgical or Endovascular Therapy

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