Although several innovations in techniques and implantable devices were reported over the last decades, a consensus on the best endovascular treatment for intracranial aneurysms originating from the posterior communicating artery is still missing. This work investigates radiological outcomes of different endovascular techniques for posterior communicating artery aneurysms treatment in a retrospective multi-centric cohort. We included patients endovascularly treated for posterior communicating artery aneurysms from 2015 through 2020 in six tertiary referral hospitals. We evaluated the relationship between patients and aneurysms characteristics, baseline neurological status, radiological outcomes, and the different endovascular techniques. Overall, 250 patients were included in this study. Simple coiling was the most frequent treatment in 171 patients (68%), followed by flow-diverter stenting in 32 cases (13%). Complete occlusion was reported in 163 patients (65%), near-complete occlusion in 43 (17%), and incomplete occlusion in 44 (18%). Radiological follow-up was available for 247 (98%) patients. The occlusion rate was stable in 149 (60%), improved in 49 (19%), and worsened in 51 (21%). No significant difference in exclusion rate was seen between ruptured and unruptured aneurysms at the last follow-up (p = 0.4). Posterior communicating artery thrombosis was reported in 25 patients (9%), transient ischemic attack in 6 (2%), and in 38 patients (15%), subsequent procedures were needed due to incomplete occlusion or reperfusion. Endovascular strategies for posterior communicating artery aneurysms represent effective and relatively safe treatments. Simple coiling provides a higher immediate occlusion rate, although recanalization has been frequently reported, conversely, flow-diversion devices provide good long-term radiological outcomes.
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Radiological outcomes for endovascular treatment of posterior communicating artery aneurysms: a retrospective multicenter study of the occlusion rate
Alba Scerrati1,2,*, Gianluca Trevisi3, Carmelo Lucio Sturiale4, Francesco Salomi1, Pasquale De
Bonis1,2, Andrea Saletti5, Annunziato Mangiola3,6, Alberto Tomatis3, Vincenzo Di
Egidio7, Vera Vigo1,8, Alessandro Pedicelli9, Iacopo Valente9, Oriela Rustemi10, Giacomo Beggio10, Giuseppe Iannucci11, Luca Milonia12, Luca Ricciardi13, Amedeo Cervo12, Guglielmo Pero12, Mariangela Piano12
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1
Department of Neurosurgery, S. Anna University Hospital, 44121 Ferrara, Italy
2
Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, 44121 Ferrara, Italy
3
Neurosurgical Unit, Santo Spirito Hospital, 65121 Pescara, Italy
4
Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00185 Rome, Italy
5
Department of Interventional Neuroradiology, S. Anna University Hospital, 44121 Ferrara, Italy
6
Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
7
Radiology Unit, Santo Spirito Hospital, 90044 Pescara, Italy
8
The Stanford Neurosurgical Training and Innovation Center, Department of Neurosurgery, Stanford University, 94305 Palo Alto, CA, USA
9
Department of Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00185 Rome, Italy
10
Department of Neurosurgery, San Bortolo Hospital, 70300 Vicenza, Italy
11
Department of Neuroradiology, San Bortolo Hospital, 70300 Vicenza, Italy
12
Department of Neuroradiology, Niguarda Hospital, 20162 Milan, Italy
13
Department of Neurosurgery, Azienda Ospedaliera Sant’Andrea, Dipartimento NESMOS, 00186 Rome, Italy
*Correspondence: scrlba@unife.it (Alba Scerrati)
J. Integr. Neurosci. 2021, 20(4), 919–931;
https://doi.org/10.31083/j.jin2004093
Submitted: 8 October 2021 | Revised: 16 November 2021 | Accepted: 18 November 2021 | Published: 30 December 2021
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract
Keywords
Posterior communicating artery aneurysms
PcomA
Fetal posterior communicating artery
Fetal variant
Endovascular
Coiling
Flow-diverters
Intrasaccular devices
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