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Neurointervention > Volume 19(3); 2024 > Article


Suh: Technical Approaches for Coil Embolization of Unruptured Small Anterior
Choroidal Artery Aneurysms: A Focus on Anatomical Flow Preservation of the
Anterior Choroidal Artery

Technical Note



Neurointervention 2024;19(3):162-168.

Print publication date: November 2024

Published online: October 15, 2024

DOI: https://doi.org/10.5469/neuroint.2024.00353






TECHNICAL APPROACHES FOR COIL EMBOLIZATION OF UNRUPTURED SMALL ANTERIOR
CHOROIDAL ARTERY ANEURYSMS: A FOCUS ON ANATOMICAL FLOW PRESERVATION OF THE
ANTERIOR CHOROIDAL ARTERY

Dae Chul Suh, MD, PhD

Department of Neurointervention, GangNam St. Peter’s Hospital, Seoul, Korea

Correspondence to: Dae Chul Suh, MD, PhD Department of Neurointervention,
GangNam St. Peter’s Hospital, 2633 Nambusoonhwan-ro, Gangnam-gu, Seoul 06268,
Korea
Tel: +82-2-3010-4352 Fax: +82-2-476-0090 E-mail: dcsuh7@gmail.com



Received August 16, 2024       Revised October 1, 2024       Accepted October 3,
2024

Copyright © 2024 Korean Society of Interventional Neuroradiology

This is an Open Access article distributed under the terms of the Creative
Commons Attribution Non-Commercial License
(http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the
original work is properly cited.



ABSTRACT

The anterior choroidal artery (AChA) supplies the corticospinal tract related to
the motor function of the upper and lower limbs. Aneurysms arising at the AChA
are not common and exhibit various patterns of involvement of the AChA. Hence,
managing an AChA aneurysm poses a high risk of neurological deficits. We report
technical issues related to the outcome of coil embolization for unruptured AChA
aneurysms. We obtained Institutional Review Board approval for this study. In
the past 2 years, 18 consecutive patients (6 males and 12 females, aged 32–68)
with unruptured AChA aneurysms were treated using embolization. We present
technical details, pre- and post-procedural patient statuses, angiographic
outcomes, and recurrence during a mean follow-up period of 12 months (range
3–25). The patients with AChA (n=18) underwent stent-assisted coiling (n=14),
coiling (n=2), or stenting only (n=2). The technical strategy for aneurysm
embolization included a low-lying approach into the aneurysm, stent-strut
abutting (protecting) coil framing to block inflow and avoid compromising AChA
flow, and direct intra-aneurysmal angiography via a microcatheter. Angiographic
results showed complete occlusion (n=11), neck remnant (n=5), and sac remnant
(n=2). During the follow-up, there were 2 recurrences, and 1 of them required a
re-procedure. All patients showed no change in clinical status (modified Rankin
scale score=0) and did not experience any ischemic or hemorrhagic events during
the follow-up period. AChA aneurysms can be managed through embolization using
various techniques. Such technical concepts may enhance the safety and improve
the outcomes of AChA aneurysm embolization.



Key Words: Aneurysm; Coil embolization; Anterior choroidal artery; Technique

Go to :



INTRODUCTION

Anterior choroidal artery (AChA) aneurysms are relatively rare, accounting for
2–5% of all intracranial aneurysms [1]. The AChA is a small artery that supplies
critical territory, including the posterior limb of the internal capsule.
Impairment of this artery may produce debilitating postoperative AchoA syndrome,
including contralateral hemiparesis [2]. The mortality rate and the
treatment-related permanent morbidity rate of surgical clipping of AchoA
aneurysms ranged from 6% to 33% and 10% to 28.6%, respectively [3]. The
incidence of postoperative infarctions after microsurgical clipping of AChA
aneurysms was reported to be between 4.8% and 7% [3].
Coiling of AChA aneurysms has comparable clinical outcomes and rebleeding
prevention to clipping, with a significantly lower incidence of AChA infarction
than clipping [1]. However, a recent systemic review showed a higher mortality
and lower morbidity rate for coiling compared to clipping [4]. These studies
were all retrospective and did not compare the initial patient status and
morphological characteristics of the aneurysms. Some biases could have been
introduced in those studies because the treatment decisions were based on the
surgical or neurointerventional capabilities of each institute. These variable
situations made the development of the embolization technique challenging,
hindering the establishment of a standardized protocol and the proposal of a
randomized controlled study to generalize treatment methods.
There have been few technical notes on AChA aneurysm embolization [5]. While the
outcomes of aneurysm embolization continue to improve, there is a need to
emphasize technical development for specific aneurysms such as AChA aneurysms.
Herein, we present a technical concept based on our recent case series in which
we were able to enhance both safety and effectiveness.
Go to :



MATERIALS AND METHODS

Eighteen consecutive patients (6 males, 12 females; aged 38–68) with unruptured
AChA aneurysms, who underwent endovascular treatment in the past 2 years, were
included from a prospectively collected hospital neurovascular database.
Inclusion criteria included patients with AChA aneurysms who underwent treatment
with stent-assisted coiling, coiling alone, or stenting. Patients with multiple
aneurysms were also included if an AChA aneurysm was treated.
Patients diagnosed with an AChA aneurysm but not treated were excluded. One
patient who underwent a cerebral angiogram for a small AChA aneurysm at our
hospital was scheduled for follow-up, while the remaining 18 patients in this
study were evaluated at external hospitals. The cohort in this study has not
been included in any other research.
This study cohort did not include any ruptured AChA aneurysms because there were
no cases of rupture during the study period. Aneurysm size criteria could not be
applied in this study because some patients who initially sought treatment from
a neurosurgeon at another hospital were required to undergo clipping, despite
having small aneurysms. Subsequently, these patients requested alternative
treatments, such as coiling and/or stenting, even after a period of observation.
The embolization procedure was the same as previously described [5-10]. Flow
diverters can be utilized as an alternative treatment option. However, they
cannot be used in Korea because the Health Insurance Review and Assessment
Service has not approved their use for aneurysms smaller than 10 mm in size and
those originating in the internal carotid artery.
Outcome evaluation was measured by post-embolization angiographic results and
final neurological status after the procedure. Angiographic results were
assessed using a 3-grade scale on the angiogram after embolization: complete
obliteration, presence of a residual neck, or presence of a residual sac. The
final neurological status of patients was assessed using the modified Rankin
scale (mRS) score, ranging from 0 (normal) to 6 (death), at the time of
discharge after the procedure and at the end of the clinical follow-up.
Recurrence of the treated aneurysm was assessed using magnetic resonance
angiography (MRA). Any progressive occlusion of remnant sac or neck was not
evaluated because MRA was the method used for evaluation and it seemed unclear
to judge whether sac and/or neck remnant were further occluded or not. We
presented technical details, pre-and post-procedural clinical status,
angiographic results, and the presence of recurrence during a mean 12-month
(3–25) follow-up period.


TECHNIQUES

The combination of embolization techniques included a low-lying approach into
the aneurysm, strut-abutting coiling compaction to avoid compromising the flow
into the AChA, and intra-aneurysmal angiography (IAA) (Fig. 1A-C). IAA was
obtained when the angiogram did not clearly demonstrate a relationship between
the aneurysm and the AChA (Fig. 2). Once the microcatheter entered the aneurysm,
IAA was performed via the microcatheter to identify the precise origin of the
AChA. Aneurysm type was categorized as axillary type, in which the AChA arose
proximal to the aneurysm, or shoulder type, in which the AChA arose distal to
the aneurysm. Medial to lateral deviation of the AChA origin from the aneurysm
was not evaluated due to the limited resolution of the angiogram, especially
when the AChA ran parallel to the aneurysm wall.

FIG. 1.

Schematic technical concept diagrams of stent-assisted coiling for an anterior
choroidal artery (AChA) aneurysm. (A) After a stent is deployed, a microcatheter
enters the aneurysm using a low-angle approach technique just above the AChA
origin through the stent. (B) Coils were packed by creating a vertical barrier
between the stent and the adjacent aneurysm wall to ensure that the flow into
the AChA was not compromised. (C) Note the triangular-shaped inflow zone
(asterisks in a magnified box figure) designed to protect the inflow zone to the
aneurysm and preserve the flow into the AChA.



FIG. 2.

To show the anterior choroidal artery (AChA) origin within the aneurysm, (A)
intra-aneurysmal injection (B) was performed to demonstrate the exact origin of
the AChA, which arose from the aneurysm sac (arrow).



Achieving a low-lying approach of the microcatheter into the aneurysm involves
creating a curve of more than 90 degrees to allow the tip of the microcatheter
to enter the aneurysm from below at the origin of the AChA. The advantage of a
low-positioned approach is to push coils into the aneurysm sac and prevent the
protrusion of coils into the entrance of the AChA [5]. If there is any coil
protrusion in front of the AChA with possible flow compromise, perform a pull
and push action of the microcatheter and coils repeatedly until the coil frame
is properly repositioned into the aneurysm (Fig. 3).

FIG. 3.

An anterior choroidal artery (AChA) aneurysm with a distinctive bleb (Case 12).
(A) Note the AChA arises in the sac. (B) A coil was introduced to establish a
flow barrier between the stent strut and the aneurysm wall (long arrow) using a
low-lying microcatheter (short arrow) positioned in front of the AChA origin.
(C) The final angiogram shows a remnant sac diverting the flow into the AChA
(arrow). (D) A 15-month follow-up magnetic resonance angiography shows no
recurrence of the aneurysm.



Regarding the repeated pull and push action, it was necessary to create a frame
to maintain a small space in front of the AChA origin to ensure that blood flow
into the AChA was not compromised (Fig. 1C). Introduction of the coil by smooth
pulling and pushing repeatedly is essential to achieve a proper coil position,
forming a stable coil frame that creates a triangular space between the stent
strut and the adjacent aneurysm wall (typically the anterior aneurysm wall) in
front of the AChA origin (Figs. 1, 3). The stent used in this study was the
Neuroform Atlas stent (Stryker Neurovascular).
Although we categorized 3 techniques, they were conceptually intertwined and not
easily separable. Since this is a procedural concept, it would be challenging to
establish any measurable criteria in an objective manner.
Go to :



RESULTS

Patients with an AChA (n=18) underwent stent-assisted coiling (n=14), coiling
(n=2), or stenting only (n=2) (Table 1). All aneurysms were axillary type with a
size range of 1.5–5.8 mm (mean 3.3 mm). Six patients had multiple aneurysms.
Angiographic results showed complete occlusion (n=11), neck remnant (n=5), and
sac remnant (n=2). During a mean 12-month follow-up period (range 3–25 months),
there were 2 recurrences.

TABLE 1.

Case summary of 18 aneurysms

Patient No. Embo Largest size (mm) No. of coils used Coils used (mm) Stent used
(mm) Packing density (%) Embo result FU MRA (m) Recurrence 1 Coiling 1.5 1 N 1×3
No stent 40 Complete 3 No 2 Coiling 4.5 3 G 5×15, N 1.5×4,1×3 No stent 39
Complete 25 No 3 Coiling 5.6 3 G 2×4, HS 1×3, N 1×3 No stent 45 Complete 17
Recur but stable 4 SAC 1.9 3 G 4×8, 3×4, N 1.5×4 Atlas 4×15 30 Complete 3 No 5
SAC 2.2 3 G 3×4, N 1×3, N 1×3 Atlas 4×15 39 Complete 9 No 6 SAC 2.4 1 N 1.5×3
Atlas 3×15 23 Complete 15 No 7 SAC 2.4 2 N 1.5×4, N 1×2 Atlas 4×15 85 Complete 3
No 8 SAC 2.5 1 N 1.5×3 Atlas 4×15 30 Complete 6 No 9 SAC 2.6 1 N 1×3 Atlas 3×15
32 Complete 18 No 10 SAC 2.8 2 N 2×4, 1×3 Atlas 4×15 46 Complete 3 No 11 SAC 4.1
1 N 1.5×3 Atlas 4×15 30 Complete 15 Recur & re-embo at 1 y 12 SAC 4.5 1 T 1.5×2
Atlas 3×15 50 Complete 15 No 13 SAC 2.6 4 G 3×6, N 2.5×4, 2×4, 1×1 Atlas 3×15 39
Neck remnant 9 No 14 SAC 2.7 1 N 2.5×6 Atlas 4×15 26 Neck remnant 13 No 15 SAC
3.7 1 N 1×3 Atlas 4×15 25 Neck remnant 15 No 16 SAC 5.8 3 G 2.5×5, N 1×3, 1×2
Atlas 4×15 45 Neck remnant 9 No 17 Stenting 2.7 0 Not used Atlas 4×21 NA Sac
remnant 3 No 18 Stenting 4 0 Not used Atlas 4×15 NA Sac remnant 19 No

Embo, embolization; FU, follow-up; MRA, magnetic resonance angiography; N,
Target Nano coils; G, Orbit Galaxy Detachable Coil System; HS, HydroSoft coils;
SAC, stent-assisted coil embolization; Atlas, Neuroform Atlas Stent System; T,
Target Tetra coils; NA, not applicable.



Among the 2 recurrent patients, 1 exhibited a small remnant sac after coiling at
the elongated neck, from which the AChA originated. The remaining sac enlarged
but remained stable at the 17-month follow-up MRA, and it was then decided not
to retreat it. The other patient underwent stent-assisted coiling for 2 adjacent
tandem aneurysms just above the AChA at the same time (Fig. 4). One-year
follow-up MRA revealed a recurrent sac had developed within the lower aneurysm,
and re-embolization was performed.

FIG. 4.

A male in his forties (Case 11) with tandem aneurysms (A) at the origin of the
right anterior choroidal artery. One year after stent-assisted coiling (B),
there was a recurrence (C). Re-embolization was performed by adding more coils
within the recurrent sac (not shown).



Stenting was done in 2 aneurysms to induce a flow-diverting effect [11-13]. One
of the aneurysms was a broad-necked aneurysm at the origin of AChA, which was
treated with stenting using the same stent that was employed for the
stent-assisted coiling of the proximal dorsal wall aneurysm. The other aneurysm
showed that the AChA originated from an aneurysmal sac on IAA so stenting of the
aneurysm was performed without coil insertion (Fig. 2). The aneurysm remained
stable in size and shape during the 3-month follow-up period. There was no
significant change in the aneurysms after stenting during the follow-up period.
The angiogram obtained at the end of the procedure demonstrated the patency of
the AChA. All patients showed no change in clinical status (mRS=0) after the
procedure, and there were no ischemic or hemorrhagic events during the follow-up
period.
Go to :



DISCUSSION

Treatment-related complication rates for AChA aneurysms varied from 4.5% to 50%
[14]. One of the main reasons for such variable outcomes depended on the vague
and complex vascular anatomy associated with the AChA. Cerebral angiography may
not depict the relationship between an aneurysm and the AChA within the aneurysm
sac [15-17].
When the AChA cannot be separated from the aneurysm itself, even 3-dimensional
rotational angiography cannot completely demonstrate the relationship of the
AChA with the aneurysm. So, the risk of compromised blood flow tended to
increase with inadvertent coil protrusion into the origin of the AChA during
embolization [14]. Therefore, the procedure would be risky and ineffective
unless there is a technical strategy to avoid such risks. Such technical
development seems crucial in determining the treatment approach and expanding
treatment options for AChA aneurysms.
Our study revealed that embolization of AChA aneurysms can be safe and effective
by applying a technical concept to create space in front of the AChA entrance.
The packing of coils in the aneurysm sac was combined with several techniques
involving a low-lying microcatheter approach into the aneurysm. This resulted in
the formation of a rather rigid coil frame in front of the AChA origin and/or
for IAA.
The critical point of the technical concept in this study is to establish an
intentional coil framework between the anterior wall of the aneurysm and the
stent strut (Fig. 1C). To achieve maximum effect, the microcatheter needed to
enter the aneurysm through the stent strut after stenting. This way, the stent
strut would physically push down into the aneurysmal sac to secure the
triangular space in front of the AChA. A coil frame with a triangular space can
resist the inflow zone of an aneurysm and improve the packing of the aneurysm
sac.
The concept described in this study has evolved from the author’s experience
with 80 out of 956 cases of AChA aneurysms [6]. Therefore, it may not be
generalized and should be implemented by experienced operators who understand
the physical characteristics of coils, stents, and microcatheters, as well as
vascular anatomical details. In addition, it would be necessary to go through
the decision-making process to determine whether an AChA aneurysm needs to be
treated or not. If treatment is required, which option would be better: surgical
clipping or endovascular management? Some patients were provided consultation
for coiling treatment when they were recommended for clipping to explore
non-surgical treatment options.
Surgical clipping still remains an option for treating AChA aneurysms. The
incidence of postoperative infarctions after microsurgical clipping of AChA
aneurysms was reported to be between 4.8% and 7% and decreased to 2.7% by using
intraoperative neuromonitoring and intraoperative indocyanine green
videoangiography (ICG-VA) [3,18,19]. However, there were 4 false-negative cases
of postoperative infarctions related to the AChA territory that exhibited patent
AChA flow on intraoperative ICG-VA due to a changed positional relationship
between the clip and the adjacent vessels. Furthermore, atherosclerosis near the
aneurysm may lead to postoperative ischemic complications following clipping.
One limitation of our study is that the technical advancements were not adopted
by all operators. A randomized controlled study is recommended to compare
efficacy, even though the incidence of this aneurysm is not common. The
technical concepts recommended by this study may not be accepted by other
operators who have experienced different outcomes. If the AChA aneurysm exhibits
an anatomical disposition different from the axillary type, as demonstrated in
our study, modified methods must be employed beyond those described herein. This
study should be subjectively understood, focusing on a descriptive approach to
technical concepts. However, this concept can also be applied to other complex
aneurysms.
This study cohort did not include any ruptured AChA aneurysms because there were
no cases of rupture during the study period. It depends on each patient’s
condition whether the same technique can also be used in the case of a ruptured
aneurysm, as surgical clipping can be another option in this emergency
situation.
For some patients who initially sought treatment from a neurosurgeon at another
hospital, clipping was required to eliminate any potential risk of rupture, even
in the presence of small aneurysms. Subsequently, these patients requested
alternative treatments, such as coiling and/or stenting. In such cases,
observation and follow-up studies may also be recommended to assess the
feasibility of monitoring the aneurysms and to alleviate anxiety caused by the
low risk of rupture, even after a period of observation.
Flow diverters can be used as an alternative treatment option. However, their
use is not permitted in Korea because the Health Insurance Review and Assessment
Service has not approved them for aneurysms smaller than 10 mm or those
originating in the internal carotid artery.
Go to :



CONCLUSION

In conclusion, AChA aneurysms can be managed through embolization with the
assistance of various techniques. The technical concept of such tactical
development may maximize device characteristics and clarify the anatomical
relationship between the AChA and the aneurysm sac. And thus, such techniques
may improve outcomes and safety in treating AChA aneurysms. Further follow-up
and a larger study may strengthen our study results.
Go to :



ACKNOWLEDGMENTS

Hyeong Hui Lee contributed to data collection and management.
Go to :



NOTES

Fund

None.

Ethics Statement

This study was approved by the Institutional Review Board of GangNam St. Peter’s
Hospital (SPH20-23-002). This paper does not include any identifying
information, such as the patients' sex or age.

Conflicts of Interest

DCS has been the Editor Emeritus of Neurointervention since 2023. However, he
has not been involved in the peer reviewer selection, evaluation, or decision
process of this article. No potential conflict of interest relevant to this
article was reported.

Go to :






REFERENCES

1. Kim BM, Kim DI, Shin YS, Chung EC, Kim DJ, Suh SH, et al. Clinical outcome
and ischemic complication after treatment of anterior choroidal artery aneurysm:
comparison between surgical clipping and endovascular coiling. AJNR Am J
Neuroradiol 2008;29:286-290.


2. Hendricks BK, Spetzler RF. Surgical challenges associated with anterior
choroidal artery aneurysm clipping: 2-dimensional operative video. Oper
Neurosurg (Hagerstown) 2020;19:E289


3. Eun C, Lee SJ, Park JC, Ahn JS, Kwun BD, Park W. Efficacy of intraoperative
neuromonitoring (IONM) and intraoperative indocyanine green videoangiography
(ICG-VA) during unruptured anterior choroidal artery aneurysm clipping surgery.
J Cerebrovasc Endovasc Neurosurg 2023;25:150-159.


4. Al Fauzi A, Rahmatullah MI, Suroto NS, Utomo B, Fahmi A, Bajamal AH, et al.
Comparison of outcomes between clipping and endovascular coiling in anterior
choroidal artery aneurysm: a systematic review. Neurosurg Rev 2023;46:276


5. Sheen JJ, Suh DC. Low-angled microcatheter approach for coil embolization of
the anterior choroidal artery aneurysm. Neuroradiology 2017;59:1053-1056.


6. Suh DC, Choi YH, Park SI, Yun S, Jeong SY, Jeong S, et al. Outpatient
day-care management of unruptured intracranial aneurysm: a retrospective cohort
study. Korean J Radiol 2022;23:828-834.


7. Song Y, Kwon B, Al-Abdulwahhab AH, Kurniawan RG, Suh DC. Microcatheter
stabilization technique using partially inflated balloon for coil embolization
of paraclinoid aneurysms. Neurointervention 2021;16:132-140.


8. Kurniawan RG, Song Y, Kwon B, Ahn Y, Suh DC. Tailored antiplatelet agent
medication in clopidogrel hyporesponsive patients before stent-assisted coiling:
single-center experience. Neuroradiology 2020;62:1709-1715.


9. Lee D, Song Y, Shin JH, Suh DC. Low-dose prasugrel in patients with
resistance to clopidogrel for the treatment of cerebral aneurysms: follow-up of
over 6 months. Neurointervention 2019;14:68-70.


10. Jia ZY, Song YS, Sheen JJ, Kim JG, Lee CW, Suh DC. Loop microcatheter
technique for coil embolization of paraclinoid aneurysms. Acta Neurochir (Wien)
2018;160:1755-1760.


11. Song Y, Choe J, Liu H, Park KJ, Yu H, Lim OK, et al. Virtual stenting of
intracranial aneurysms: application of hemodynamic modification analysis. Acta
Radiol 2016;57:992-997.


12. Park W, Song Y, Park KJ, Koo HW, Yang K, Suh DC. Hemodynamic characteristics
regarding recanalization of completely coiled aneurysms: computational fluid
dynamic analysis using virtual models comparison. Neurointervention
2016;11:30-36.


13. Liu H, Choe J, Jung SC, Song Y, Yang KH, Park KJ, et al. Does a low-wall
coverage stent have a flow diverting effect in small aneurysms?
Neurointervention 2015;10:89-93.


14. André A, Boch AL, Di Maria F, Nouet A, Sourour N, Clémenceau S, et al.
Complication risk factors in anterior choroidal artery aneurysm treatment. Clin
Neuroradiol 2018;28:345-356.


15. Wolman DN, Moraff AM, Heit JJ. Anatomy of the intracranial arteries: the
internal carotid artery. Neuroimaging Clin N Am 2022;32:603-615.


16. Duan Y, Qin X, An Q, Liu Y, Li J, Chen G. A new classification of anterior
choroidal artery aneurysms and its clinical application. Front Aging Neurosci
2021;13:596829


17. Park J, Kim JS. Infundibular widening of angiographically invisible
duplicate anterior choroidal artery mimicking typical anterior choroidal artery
aneurysm. J Korean Neurosurg Soc 2023;66:105-110.


18. Irie T, Yoshitani K, Ohnishi Y, Shinzawa M, Miura N, Kusaka Y, et al. The
efficacy of motor-evoked potentials on cerebral aneurysm surgery and new-onset
postoperative motor deficits. J Neurosurg Anesthesiol 2010;22:247-251.


19. Szelényi A, Langer D, Kothbauer K, De Camargo AB, Flamm ES, Deletis V.
Monitoring of muscle motor evoked potentials during cerebral aneurysm surgery:
intraoperative changes and postoperative outcome. J Neurosurg 2006;105:675-681.


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Abstract
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSION
Acknowledgments
Notes
REFERENCES
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