Complication Risk Factors in Anterior Choroidal Artery Aneurysm Treatment

The anterior choroidal artery (AChoA) is a rare location for intracranial aneurysms. The treatment of these aneurysms may be challenging due to the risk of occlusion of such a small and eloquent artery as the AChoA. We aimed to evaluate the risk factors for complications in AChoA aneurysm treatment. We retrospectively analyzed 47 consecutive AChoA aneurysms in 40 patients treated in our institution from 1999 and 2014 by endovascular means (87%) or surgical clipping (13%). Minor (transient or minor neurological deficits) and major complications (severe permanent neurological deficits or death) were systematically recorded. The influence of patient age, sex, aneurysm size, neck size, shape, dome-to-neck ratio and treatment technique on the occurrence of procedure-related complications was evaluated. Of the patients 11 experienced procedure-related complications (5 major, 6 minor). Aneurysms with multilobed shape were significantly associated with a higher procedure-related complication rate. There was a tendency for higher major procedure-related complication rate in small volume aneurysms. We did not find any association between the other factors analyzed and occurrence of procedure-related complications. Treatment of AChoA aneurysms has an acceptable complication risk. We did not find any significant differences between surgical and endovascular treatment in terms of procedure-related complication rates. Multilobed aneurysms were significantly associated with a higher procedure-related complication rate.