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Review
. 2024 Feb 20;166(1):94.
doi: 10.1007/s00701-024-05988-1.

Internal carotid artery-persistent primitive anterior choroidal artery aneurysms: report of two cases and literature review

Yasuyuki Tatsuta  1 , Hideki Endo  2 , Tatsuya Ogino  2 , Yohei Yamaguchi  2 , Kenji Kamiyama  2 , Toshiaki Osato  2 , Hirohiko Nakamura  2
Affiliations
Review

Internal carotid artery-persistent primitive anterior choroidal artery aneurysms: report of two cases and literature review

Yasuyuki Tatsuta et al. Acta Neurochir (Wien). .

Abstract

Purpose: Persistent primitive anterior choroidal artery (PPAChA) is a rare vascular anomaly. The clinical course of internal carotid artery (ICA)-PPAChA aneurysms has not been well described.

Case reports: We report two patients with an ICA-PPChA aneurysm and summarize previously reported cases.

Results: Including our two, a total of 10 patients with an ICA-PPAChA aneurysm have been reported. Data were not described for one. Among the remaining nine, five patients (56%) experienced aneurysmal rupture. Five patients underwent surgical clipping and four underwent endovascular coiling. The procedure was completed in all but one patient who had a tiny branch artery adherent to the aneurysm; this patient was converted from clipping to aneurysm coating with a cotton sheet. Among the other eight patients, one who underwent coiling experienced an internal capsule infarction. The remaining seven had a satisfactory postoperative course; however, an asymptomatic occlusion of the PPAChA at its origin was noted on postoperative angiography in one.

Conclusion: PPChA is associated with a high incidence of aneurysm formation and rupture. During treatment of ICA-PPAChA aneurysms, obstruction of the PPAChA and any surrounding perforating arteries should be avoided to prevent ischemic stroke.

Keywords: Anatomical variant; Anterior choroidal artery; Cerebral aneurysm; Endovascular treatment; Surgical clipping.

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