Stent-assisted Coiling for a Wide-neck AnteriorCommunicating Artery Aneurysm: A Case Report

Background: Aneurysms of the anterior communicating artery (AComA) are a frequent cause of subarachnoid hemorrhage. They present significant challenges in endovascular management due to complex vascular anatomy and the need to preserve critical perforating arteries. Stent-assisted coiling (SAC) has emerged as a reliable technique for wide-neck AComA aneurysms, offering favorable occlusion rates while minimizing periprocedural complications. Case Presentation: We present a 42-year-old male with an incidentally discovered, unruptured wide-neck AComA aneurysm identified during evaluation for his mild, intermittent frontal headaches. Digital subtraction angiography (DSA) revealed a superolateral projecting aneurysm with a neck width of 3.6 mm and an aspect ratio of 1.1. Considering the aneurysm’s morphological complexity and potential risk of rupture, stent-assisted coil embolization using the jailing technique was performed. A Neuroform Atlas stent was deployed from the proximal A2 to A1 segment to secure the microcatheter during coiling. Post-procedural angiography demonstrated complete aneurysm occlusion without parent vessel compromise. The patient remained neurologically intact and was discharged three days post-procedure. At one-year follow-up, imaging confirmed stable occlusion with no evidence of recurrence or delayed complications. Conclusion: SAC using the jailing technique represents a safe and effective therapeutic strategy for wide-neck AComA aneurysms, providing durable aneurysm occlusion while preserving vessel patency. Further comparative studies are warranted to evaluate long-term outcomes across different endovascular techniques in managing AComA aneurysms.