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Updated: Mar 23, 2026
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
A new endovascular technique for small anterior choroidal artery aneurysms. A consecutive series using the
Hélène Gimonet1, Hubert-Armand Desal1, Pascal J Mosimann2
1Service de neuroradiologie diagnostique et interventionnelle, hôpital Guillaume-et-René-Laennec, CHU de Nantes, boulevard Jacques-Monod-Saint-Herblain, 44093 Nantes cedex 1, France.
Introduction:
Endovascular treatment of small anterior choroidal artery (AChA) aneurysms can be challenging, especially if the AChA arises from the sac. Preserving its patency during embolization is as important as obliterating the aneurysm. We describe a variant of the "protective microcatheter technique" (PMT) in a series of six patients with AChA aneurysms where the AChA emerged from the sac.
Methods:
Three different microcatheters (KT) were used. The first microcatheter was placed in the AChA to protect it. A remodeling balloon-catheter was then positioned in the internal carotid artery to stabilize the coils during embolization and to control a potential rupture. The third microcatheter was finally used to coil the aneurysm.
Results:
Mean sac size of anterior choroidal artery aneurysms was 2×2×2mm. All aneurysms were successfully occluded. There was neither ischemic complication nor ruptured aneurysm during endovascular treatment. A final angiogram demonstrated AChA patency in all cases.
Conclusion:
The 3KT-PMT for AChA aneurysms appears to be safe and effective to prevent AChA occlusion during aneurysm coiling, especially when the AChA arises from the sac.
