Endovascular Treatment Of Ruptured Tiny Aneurysms Of Anterior Cerebral Artery Proximal A1 By Stent-assisted Coiling Technique

Objective:to evaluate the feasibility,effectiveness,and safety of the embolization of the ruptured,tiny aneurysms of anterior cerebral artery proximal A1 by stent-assisted coiling technique.Methods:The clinical data of 11 patients with AC A proximal A1 segment wide-necked aneurysms,who were treated in the First Affiliated Hospital of Chongqing Medical University from January 2010 to December 2018,were analyzed retrospectively.The degree of immediate embolization was evaluated according to Raymond classification.Imaging follow-up was performed using DSA,and clinical prognosis was followed by outpatient or telephone follow-up.The prognosis was assessed using a modified Rankin Scale(mRS)score.Results:11 patients were treated with by stent-assisted coils embolization.Patient-specific catheter shaping was performed in all the patients,of whom 6 had formed to "S" shape,4 "Z" shape and 1"pig tail".The outcomes were Raymond grade I in 8 patients,grade Ⅱ in 2 and gradeⅢ in 1 immediately after the embolization.Ischemic event occurred in 1 patient 3 days after the operation,without neurological disorders on discharge.No ischemic events occurred in all the patients during the follow-up(range,10～31 months;mean,18.4 months;median,17 months).The follow-up(range,6～12 months)DSA images showed Raymond grade I in 9 patients and grade II in 2.The outcomes of clinical follow-up(range,6～12 months)showed modified Rankin scale score of 0～2 in 9 patients,3 in 1,and 4 in 1.Conclusion:Stent-assisted coiling of ruptured tiny aneurysms of anterior cerebral artery proximal A1 provides occlusion at follow-up with an excellent safety profile.