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Abstract：
BACKGROUND: Lobulated intracranial aneurysm is a special type of aneurysm with at least one additional cyst in the neck or body of the aneurysm. Lobulated intracranial aneurysm is a complex aneurysm with complex morphology and structure and weak tumor wall, which is an independent risk factor for rupture and hemorrhage. Lobular aneurysms located in the anterior communicating artery complex account for 36.9% of all intracranial lobular aneurysms. Due to its special anatomical structure, both craniotomy and endovascular treatment are more difficult. Compared with single-capsule aneurysms, craniotomy for lobular intracranial aneurysms has a higher risk and complication rate.
OBJECTIVE: To investigate the efficacy and safety of endovascular treatment for ruptured lobulated anterior communicating artery aneurysm (ACoAA).
METHODS: Patients with ruptured lobulated ACoAA received endovascular treatment in Sanming First Hospital Affiliated to Fujian Medical University from June 2020 to June 2022 were retrospectively included. Their demographic, clinical and imaging characteristics, endovascular treatment methods and follow-up results were collected.
RESULTS: A total of 24 patients with ruptured lobulated ACoAA were included, including 9 males (37.5%) and 15 females (62.5%). Their age was 56.2 ± 8.9 years old (range 39-74). The time from rupture to endovascular treatment was 10.9 ± 12.5 h. The maximum diameter of the aneurysms was 5.1 ± 1.0 mm and neck width were 3.0 ± 0.7 mm. Nineteen patients (79.2%) were double-lobed and 5 (20.8%) were multilobed. Fisher\'s grade: Grade 2 in 16 cases (66.7%), grade 3 in 6 cases (25%), and grade 4 in 2 cases (8.3%). Hunt-Hess grade: Grade 0-2 in 5 cases (20.8%), grade 3-5 in 19 cases (79.2%). Glasgow Coma Scale score: 9-12 in 14 cases (58.3%), 13-15 in 10 cases (41.7%). Immediately postprocedural Raymond-Roy grade: grade 1 in 23 cases (95. 8%), grade 2 in 1 case (4.2%). Raymond-Roy grade in imaging follow-up for 2 wk to 3 months: grade 1 in 23 cases (95.8%), grade 2 in 1 case (4.2%). Follow-up for 2 to 12 months showed that 21 patients (87.5%) had good functional outcomes (modified Rankin Scale score ≤ 2), and there were no deaths.
CONCLUSIONS: Endovascular treatment is a safe and effective treatment for ruptured lobulated AcoAA.
OBJECTIVE: To investigate the efficacy and safety of endovascular treatment for ruptured lobulated anterior communicating artery aneurysm (ACoAA).
METHODS: Patients with ruptured lobulated ACoAA received endovascular treatment in Sanming First Hospital Affiliated to Fujian Medical University from June 2020 to June 2022 were retrospectively included. Their demographic, clinical and imaging characteristics, endovascular treatment methods and follow-up results were collected.
RESULTS: A total of 24 patients with ruptured lobulated ACoAA were included, including 9 males (37.5%) and 15 females (62.5%). Their age was 56.2 ± 8.9 years old (range 39-74). The time from rupture to endovascular treatment was 10.9 ± 12.5 h. The maximum diameter of the aneurysms was 5.1 ± 1.0 mm and neck width were 3.0 ± 0.7 mm. Nineteen patients (79.2%) were double-lobed and 5 (20.8%) were multilobed. Fisher\'s grade: Grade 2 in 16 cases (66.7%), grade 3 in 6 cases (25%), and grade 4 in 2 cases (8.3%). Hunt-Hess grade: Grade 0-2 in 5 cases (20.8%), grade 3-5 in 19 cases (79.2%). Glasgow Coma Scale score: 9-12 in 14 cases (58.3%), 13-15 in 10 cases (41.7%). Immediately postprocedural Raymond-Roy grade: grade 1 in 23 cases (95. 8%), grade 2 in 1 case (4.2%). Raymond-Roy grade in imaging follow-up for 2 wk to 3 months: grade 1 in 23 cases (95.8%), grade 2 in 1 case (4.2%). Follow-up for 2 to 12 months showed that 21 patients (87.5%) had good functional outcomes (modified Rankin Scale score ≤ 2), and there were no deaths.
CONCLUSIONS: Endovascular treatment is a safe and effective treatment for ruptured lobulated AcoAA.
摘要：
背景：小叶性颅内动脉瘤是一种特殊类型的动脉瘤，在动脉瘤的颈部或体内至少有一个额外的囊肿。小叶性颅内动脉瘤是一种形态结构复杂、瘤壁薄弱的复杂动脉瘤,这是破裂出血的独立危险因素。位于前交通动脉复合体的小叶动脉瘤占所有颅内小叶动脉瘤的36.9%。由于其特殊的解剖结构,开颅手术和血管内治疗都比较困难.与单囊动脉瘤相比，颅内小叶动脉瘤开颅手术具有较高的风险和并发症发生率。
目的：探讨腔内治疗破裂分叶前交通动脉瘤（ACoAA）的疗效和安全性。
方法：对2020年6月至2022年6月在福建医科大学附属三明市第一医院行血管内治疗的ACoAA破裂患者进行回顾性研究。他们的人口统计，临床和影像学特征，收集血管内治疗方法和随访结果。
结果：共纳入24例分叶型ACoAA破裂患者，其中男性9人(37.5%),女性15人(62.5%)。他们的年龄为56.2±8.9岁（范围39-74）。从破裂到血管内治疗的时间为10.9±12.5h。动脉瘤的最大直径为5.1±1.0mm，颈部宽度为3.0±0.7mm。19例（79.2％）为双叶，5例（20.8％）为多叶。费希尔等级：16例2级（66.7%），3级6例（25%），4级2例(8.3%)。Hunt-Hess等级:0-2级5例(20.8%),3-5级19例(79.2%)。格拉斯哥昏迷量表评分：9-12例（58.3%），14例10例中13-15例(41.7%)。术后即刻Raymond-Roy等级：1级23例(95。8%),1例2级（4.2%）。Raymond-Roy级影像随访2周至3个月:1级23例(95.8%),1例2级（4.2%）。随访2～12个月,21例(87.5%)患者功能预后良好(改良Rankin量表评分≤2分),也没有人死亡.
结论：血管内治疗是一种安全有效的治疗方法。
目的：探讨腔内治疗破裂分叶前交通动脉瘤（ACoAA）的疗效和安全性。
方法：对2020年6月至2022年6月在福建医科大学附属三明市第一医院行血管内治疗的ACoAA破裂患者进行回顾性研究。他们的人口统计，临床和影像学特征，收集血管内治疗方法和随访结果。
结果：共纳入24例分叶型ACoAA破裂患者，其中男性9人(37.5%),女性15人(62.5%)。他们的年龄为56.2±8.9岁（范围39-74）。从破裂到血管内治疗的时间为10.9±12.5h。动脉瘤的最大直径为5.1±1.0mm，颈部宽度为3.0±0.7mm。19例（79.2％）为双叶，5例（20.8％）为多叶。费希尔等级：16例2级（66.7%），3级6例（25%），4级2例(8.3%)。Hunt-Hess等级:0-2级5例(20.8%),3-5级19例(79.2%)。格拉斯哥昏迷量表评分：9-12例（58.3%），14例10例中13-15例(41.7%)。术后即刻Raymond-Roy等级：1级23例(95。8%),1例2级（4.2%）。Raymond-Roy级影像随访2周至3个月:1级23例(95.8%),1例2级（4.2%）。随访2～12个月,21例(87.5%)患者功能预后良好(改良Rankin量表评分≤2分),也没有人死亡.
结论：血管内治疗是一种安全有效的治疗方法。
