Abstract WP77: Safety and Efficacy of Endovasucular Treatment of Superior Hypophyeal Artery Aneurysms: A Review of 86 Cases

BACKGROUND AND PURPOSE: Given the challenges posed by surgical clipping, endovascular techniques have been increasingly used to treat superior hypophyeal artery(SHA) aneurysms. The purpose of this study was to assess the safety and efficacy of endovascular techniques in the treatment of SHA aneurysms. MATERIAL AND METHODS: Medical charts and initial and follow-up magnetic resonance angiography(MRA) were reviewed retrospectively for all patients treated with endovascular procedures at our institution between January 2000 and July 2012. RESULTS: We identified 86 patients with SHA aneurysms who were treated with endovascular techniques. Of these patients, 75 were women and only 11 were men (87.2% female predominance). Patients age ranged between 23 and 86 years with a mean of 53.4. Ruputured aneurysms accounted for 9.3% (8/86) of all aneurysms. Average aneurysm size was 5.9 mm and raged from 3.6 to 16.4mm. Ten patients were treated with coil embolization; 72, with balloon-assisted coil embolization; 3, with stent-assisted coiling; 1, with balloon and double catheter coiling; one patient was given up. Complete or near-complete aneurysm occlusion (>95%) was achieved in 96.5% (83/86). Procedure-related complications occurred in 3.4% (3/86). Thromboembolic complication was seen in one patient, one patient also suffered an intra-procedural aneurysm rupture, one patient occurred puncture hematoma. Imaging follow-up was available for 64% (55/86) of patients (MRA) at a mean time point of 24 months (range, 6-101). 3 patients had a recurrence (3.4%), but none of the patients had a retreated. CONCLUSION: SHA aneurysms have the lowest recurrence rate with endovascular treatment compared with aneurysms in other locations by using historical data. Because of its safety and efficacy, endovascular therapy should be considered the procedure of choice for the treatment of SHA aneurysms.