Clinical efficacy of endovascular treatment of posterior communicating artery aneurysms with fetal posterior cerebral artery / 中国脑血管病杂志

ABSTRACT

Objective To evaluate the safety and efficacy of endovascular treatment of posterior communicating artery (PCoA) aneurysms with fetal posterior cerebral artery (fPCA). Methods From January 2015 to December 2017,55 consecutive patients with PCoA aneurysm with fPCA (57 aneurysms) treated at the Department of Neurosurgery, First Hospital Affiliated to Naval Military Medical University were enrolled retrospectively. All aneurysms were treated with endovascular treatment, including 27 aneurysms treated with coils alone and 30 treated with stent-assisted embolizatioa The immediate degree of embolization after procedure was assessed according to the Raymond grade. Imaging follow-up was performed using DSA or MR angiography, and the clinical prognosis was followed up by the outpatient and/or telephone. The prognosis was assessed using the modified Rankin scale (MRS) score. Results Of the 55 patients ,41 (74. 5% ) had subarachnoid hemorrhage. Immediate post-operative angiography revealed that 21 aneurysms (36. 8% ) were Raymond grade 1,11 aneurysms (19. 3% ) were Raymond grade E ,and 25 aneurysms (43. 9% ) were Raymond grade HI. All the PCoAs were patent Three patients (5.5%) had perioperative complications, they were operation-related bleeding.no ischemic events occurred,and 3 patients died. Thirty-nine patients with 41 aneurysms were followed up with imaging, of which 26 (63. 4% ) were cured, 1 (2. 4% ) were improved,8 ( 19. 5% ) were stable, and 6 (14. 6% ) recurred ( all treated with coils alone). All PCoAs with fPCA remained patent during the follow-up. Of the 52 patients who were clinically followed up,2 died and the aneurysm of 1 ease reruptured one year after procedure. The follow-up MRS score was 0-2 in 47 cases (90.4% ) ,3 in 1 case,4 in 1 case,5 in 1 case,and 6 in 2cases. Conclusion Endovascular treatment of PCoA aneurysms with fPCA is feasible and effective.