{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T14:31:31Z","timestamp":1783607491986,"version":"3.55.0"},"reference-count":25,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Distal anterior cerebral artery (ACA) aneurysms are rare, representing 1\u20139% of all intracranial aneurysms. The best treatment strategy for these aneurysms continues to be debated. We clarified the clinical features and treatment outcomes of patients with ruptured distal ACA aneurysms according to the treatment options at our institute.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>Thirty-seven consecutive patients (26 women; mean age, 65.2 years) with ruptured distal ACA aneurysms who underwent surgical clipping or coil embolization between 2012 and 2018 were included in the study. Clinical presentations, radiographic findings, and outcomes were retrospectively reviewed and compared between patients who underwent either surgical clipping or coil embolization. Risk factors associated with poor outcomes (modified Rankin Scale 4\u20136) were analyzed using multiple regression analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>Nineteen patients (51.4%) had World Federation Neurological Surgeons (WFNS) Grade IV-V, 18 (48.7%) had frontal lobe hematomas, and 13 (35.1%) had multiple aneurysms. Surgical clipping and endovascular coiling were performed in 28 (75.7%) and nine (24.3%) patients, respectively. Aneurysms located at the A4-5 portions were mainly treated by surgical clipping (<jats:italic>P<\/jats:italic> = 0.04). There were no significant between-group differences in procedure-related morbidity and mortality; however, the complete occlusion rate was higher in the surgical group (<jats:italic>P<\/jats:italic> &lt; 0.01). Overall, a favorable neurological outcome at discharge (mRS 0\u20133) was obtained in 23 patients (62.5%). Multiple regression analysis revealed that WFNS Grade IV-V and frontal lobe hematomas were risk factors for poor outcomes (mRS 4\u20136).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Acceptable outcomes were obtained in 62.5% of cases, and there were no significant between-group differences in treatment results between clipping and coiling. A poor WFNS grade and intracerebral hematomas were risk factors for a poor prognosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_223_2021","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T13:25:15Z","timestamp":1618838715000},"page":"171","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Current treatment options and prognostic factors for ruptured distal anterior cerebral artery aneurysms"],"prefix":"10.25259","volume":"12","author":[{"given":"Yushiro","family":"Take","sequence":"first","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Kamide","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Kikkawa","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Ikegami","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Teranishi","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuro","family":"Ehara","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoto","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaima","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiki","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Iihoshi","sequence":"additional","affiliation":[{"name":"Department of Neuroendovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Kohyama","sequence":"additional","affiliation":[{"name":"Department of Neuroendovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Kurita","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"10.25259\/SNI_223_2021\/ref-1","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.neuchi.2015.03.010","article-title":"Pericallosal aneurysm: A difficult challenge for microsurgery and endovascular treatment","volume":"61","author":"Abouka\u00efs","year":"2015","journal-title":"Neurochirurgie"},{"key":"10.25259\/SNI_223_2021\/ref-2","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1179\/016164110X12556180205951","article-title":"The influence of configuration and location of ruptured distal cerebral anterior artery aneurysms on their treatment modality and results: Analysis of our casuistry and literature review","volume":"32","author":"Carvi y Nievas","year":"2010","journal-title":"Neurol Res"},{"key":"10.25259\/SNI_223_2021\/ref-3","first-page":"653","article-title":"Review of the anatomy of the distal anterior cerebral artery and its anomalies","volume":"26","author":"Cilliers","year":"2016","journal-title":"Turk Neurosurg"},{"key":"10.25259\/SNI_223_2021\/ref-4","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/S0090-3019(99)00066-X","article-title":"Distal anterior cerebral artery aneurysms","volume":"52","author":"de Sousa","year":"1999","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_223_2021\/ref-5","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1136\/jnis.2011.004770","article-title":"Microsurgical and endovascular management of pericallosal aneurysms","volume":"3","author":"Hui","year":"2011","journal-title":"J Neurointerv Surg"},{"key":"10.25259\/SNI_223_2021\/ref-6","doi-asserted-by":"crossref","first-page":"517","DOI":"10.3171\/jns.2003.99.3.0517","article-title":"Surgical strategy for distal anterior cerebral artery aneurysms: Microsurgical anatomy","volume":"99","author":"Kawashima","year":"2003","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_223_2021\/ref-7","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1227\/01.neu.0000317307.16332.03","article-title":"Distal anterior cerebral artery aneurysms: Treatment and outcome analysis of 501 patients","volume":"62","author":"Lehecka","year":"2008","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_223_2021\/ref-8","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/0090-3019(84)90199-X","article-title":"Aneurysms of the pericallosalcallosomarginal junction","volume":"21","author":"Mann","year":"1984","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_223_2021\/ref-9","doi-asserted-by":"crossref","first-page":"762","DOI":"10.3171\/jns.1960.17.4.0762","article-title":"An analysis of the results of treatment of ruptured intracranial aneurysms, report of 772 consecutive cases","volume":"17","author":"McKissock","year":"1960","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_223_2021\/ref-10","first-page":"11","article-title":"Coiling of ruptured pericallosal artery aneurysms","volume":"50","author":"Menovsky","year":"2002","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_223_2021\/ref-11","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1227\/00006123-199012000-00008","article-title":"Saccular aneurysms of the distal anterior cerebral artery","volume":"27","author":"Ohno","year":"1990","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_223_2021\/ref-12","doi-asserted-by":"crossref","first-page":"304","DOI":"10.2176\/nmc.53.304","article-title":"Feasibility and efficacy of endovascular therapy for ruptured distal anterior cerebral artery aneurysms","volume":"53","author":"Oishi","year":"2013","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_223_2021\/ref-13","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4103\/1793-5482.85628","article-title":"Surgical Strategies and outcomes for distal anterior cerebral arteries aneurysms","volume":"6","author":"Orz","year":"2011","journal-title":"Asian J Neurosurg"},{"key":"10.25259\/SNI_223_2021\/ref-14","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1227\/01.neu.0000303186.26684.81","article-title":"Management of distal anterior cerebral artery aneurysms: A single institution retrospective analysis (1997-2005)","volume":"61","author":"Pandey","year":"2007","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_223_2021\/ref-15","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1111\/jon.12073","article-title":"The role of endovascular treatment for ruptured distal anterior cerebral artery aneurysms: Comparison with microsurgical clipping","volume":"25","author":"Park","year":"2015","journal-title":"J Neuroimaging"},{"key":"10.25259\/SNI_223_2021\/ref-16","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.wneu.2016.11.134","article-title":"Safety and efficacy of surgical and endovascular treatment for distal anterior cerebral artery aneurysms: A systematic review and meta-analysis","volume":"100","author":"Petr","year":"2017","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_223_2021\/ref-17","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1080\/01616412.1996.11740377","article-title":"Endovascular treatment of pericallosal artery aneurysms","volume":"18","author":"Pierot","year":"1996","journal-title":"Neurol Res"},{"key":"10.25259\/SNI_223_2021\/ref-18","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.1161\/01.STR.28.12.2405","article-title":"Outcome in 43 patients with distal anterior cerebral artery aneurysms","volume":"28","author":"Proust","year":"1997","journal-title":"Stroke"},{"key":"10.25259\/SNI_223_2021\/ref-19","first-page":"1787","article-title":"Aneurysms of the distal anterior cerebral artery. A report on 24 verified cases","volume":"47","author":"Snyckers","year":"1973","journal-title":"S Afr Med J"},{"key":"10.25259\/SNI_223_2021\/ref-20","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1227\/01.NEU.0000249267.33945.E7","article-title":"Aneurysms of the distal anterior cerebral artery: Results in 59 consecutively managed patients","volume":"60","author":"Steven","year":"2007","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_223_2021\/ref-21","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.3174\/ajnr.A3629","article-title":"Endovascular treatment of distal anterior cerebral artery aneurysms: single-center experience and a systematic review","volume":"34","author":"Sturiale","year":"2013","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_223_2021\/ref-22","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1177\/159101991101700108","article-title":"Outcomes analysis of ruptured distal anterior cerebral artery aneurysms treated by endosaccular embolization and surgical clipping","volume":"17","author":"Suzuki","year":"2011","journal-title":"Interv Neuroradiol"},{"key":"10.25259\/SNI_223_2021\/ref-23","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.surneu.2007.07.058","article-title":"Endovascular therapy of distal anterior cerebral artery aneurysms-an effective treatment option","volume":"70","author":"Waldenberger","year":"2008","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_223_2021\/ref-24","doi-asserted-by":"crossref","first-page":"409","DOI":"10.2176\/nmc.53.409","article-title":"Endovascular coiling as the first treatment strategy for ruptured pericallosal artery aneurysms: Results, complications, and follow up","volume":"53","author":"Yamazaki","year":"2013","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_223_2021\/ref-25","doi-asserted-by":"crossref","first-page":"218","DOI":"10.3171\/jns.1974.40.2.0218","article-title":"Saccular aneurysms of the distal anterior cerebral artery","volume":"40","author":"Ya\u015fargil","year":"1974","journal-title":"J Neurosurg"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/current-treatment-options-and-prognostic-factors-for-ruptured-distal-anterior-cerebral-artery-aneurysms","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/current-treatment-options-and-prognostic-factors-for-ruptured-distal-anterior-cerebral-artery-aneurysms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,26]],"date-time":"2022-01-26T08:00:22Z","timestamp":1643184022000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/current-treatment-options-and-prognostic-factors-for-ruptured-distal-anterior-cerebral-artery-aneurysms"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,19]]},"references-count":25,"alternative-id":["10.25259\/SNI_223_2021"],"URL":"https:\/\/doi.org\/10.25259\/sni_223_2021","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,19]]},"article-number":"171"}}