Evidence map›Paper›PMID 41909376›Full record

ArticleCureus2026

Management of Distal Anterior Cerebral Artery Aneurysms in a Tertiary Center in Pakistan: A Retrospective Analysis of Treatment Modalities and Angiographic and Short-Term Functional Outcomes.

Talha Sajid, Faiq Sheikh, Muhammad Naveed Majeed, Khawar Zaman, Muhammad Zahid Ullah, Ansarullah Khan, Muhammad A Zafar, Abdul Majid, Qasim Bashir

Abstract read
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Talha SajidNeurological Surgery, Punjab Institute of Neurosciences, Lahore, PAK.
Faiq SheikhNeurological Surgery, Punjab Institute of Neurosciences, Lahore, PAK.
Muhammad Naveed MajeedNeurological and Neuroendovascular Surgery, Punjab Institute of Neurosciences, Lahore, PAK.
Khawar ZamanNeurological Surgery, Punjab Institute of Neurosciences, Lahore, PAK.
Muhammad Zahid UllahNeurological Surgery, Punjab Institute of Neurosciences, Lahore, PAK.
Ansarullah KhanNeurological Surgery, Punjab Institute of Neurosciences, Lahore, PAK.
Muhammad A ZafarNeurological Surgery, Punjab Institute of Neurosciences, Lahore, PAK.
Abdul MajidNeurological Surgery, Punjab Institute of Neurosciences, Lahore, PAK.
Qasim BashirClinical and Interventional Neurology, Punjab Institute of Neurosciences, Lahore, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Distal anterior cerebral artery (dACA) aneurysms are an uncommon subset of intracranial aneurysms and pose unique anatomical and technical challenges due to their deep midline location and complex vascular anatomy. While management outcomes are well described in high-resource settings, data from low- and middle-income countries (LMICs) remain limited, particularly in the context of treatment delays and resource-driven decision-making. Objective The objective of the study is to describe the treatment pathways, immediate angiographic occlusion rates, periprocedural complications, and short-term functional outcomes of dACA aneurysms managed with microsurgical clipping or endovascular coiling at a tertiary care center in Pakistan. Methods This single-center retrospective descriptive study included consecutive patients with radiologically confirmed saccular dACA aneurysms (A2-A5 segments) treated between January 2023 and July 2025. Patients underwent microsurgical clipping or endovascular coiling based on institutional practice pathways and clinical judgment. Angiographic outcomes were assessed using postoperative imaging, with Raymond-Roy classification applied for coiled aneurysms. Functional outcomes were evaluated using the modified Rankin Scale (mRS) at discharge and at the 30-day follow-up. Results A total of 49 patients were included, with a mean age of 47 years; 29 patients (59.1%) were female, and 47 patients (96%) presented with ruptured aneurysms. Microsurgical clipping was performed in 43 patients (87.8%), while six patients (12.2%) underwent endovascular coiling. The mean interval from diagnosis to definitive treatment was 18.2 ± 2.9 days, with no documented rebleeding prior to intervention. Complete aneurysm occlusion was achieved in 42 of 43 clipped aneurysms (97.7%) and in six of six coiled aneurysms (100%). At the 30-day follow-up, 44 patients (89.8%) were functionally independent (mRS 0-2), with no mortality reported. Conclusion In a resource-limited setting with significant treatment delays, definitive management of dACA aneurysms using microsurgical clipping or selective endovascular coiling achieved excellent immediate angiographic results and favorable short-term functional outcomes. These findings demonstrate the feasibility of managing this complex pathology within systemic constraints when treatment strategies are tailored to institutional capabilities.

Indexed as

anterior cerebral arteryintracranialmilrinonesubarachnoid hemorrhagevasospasm

Identifiers

PMID41909376
PMCPMC13020119

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.