True Aneurysms of the Posterior Communicating Artery: A Systematic Review and Meta-Analysis of Individual Patient Data

He, Wenzhuan; Gandhi, Chirag D.; Quinn, John C.; Karimi, Reza; Prestigiacomo, Charles J.

doi:10.1016/j.wneu.2010.09.012

Cited by 54 publications

(47 citation statements)

References 58 publications

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“…Many important vessels branch from the PcomA to supply the optic chiasm, oculomotor nerve, ventral thalamus, mammillary body, tuber cinereum, hypothalamus, and internal capsule. 1 However, ischemic complications following coil embolization of PcomA aneurysms are not fully understood, especially when the PcomA is sacrificed. 16 Although the Allcock test is considered useful for evaluating collateral blood flow, to predict postoperative ischemic complications of PcomA sacrifice, the ramifications of sacrificing the PcomA orifice in patients with PcomA aneurysms are still unknown.…”

Section: Discussionmentioning

confidence: 99%

“…1 Due to anatomic variations in parent arteries and the array of configurations displayed by the aneurysms themselves, these lesions may be among the easiest or the most difficult to treat by any means, surgical or endovascular. 2 Technologic advancements and improved coiling techniques have made it possible to treat a large percentage of oddly configured aneurysms, otherwise inconducive to endovascular coil embolization.…”

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confidence: 99%

See 1 more Smart Citation

Stent-Assisted Coil Embolization of Posterior Communicating Artery Aneurysms

Cho¹,

Lee²,

Kim³

et al. 2013

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Use of protective stents may not be effective in coil embolization of wide-neck aneurysms involving the posterior communicating artery. Successful implementation depends on the caliber of the vessel, its angle of origin, and the manner in which its orifice is incorporated into the aneurysm. Presented here are the results (clinical and radiographic) of coil embolization in aneurysms of the ICA-posterior communicating artery junction, variably aided by stents. The primary focus is angiographic configurations that impact stent placement.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Stent-Assisted Coil Embolization of Posterior Communicating Artery Aneurysms

Cho¹,

Lee²,

Kim³

et al. 2013

AJNR Am J Neuroradiol

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“…Several studies have reported that PCoA and anterior communicating artery aneurysms are more prone to rupture than aneurysms in other parts (2,3,4,5). In the analysis of the available information from the included case reports and case series, 44 of 49 (89.8%) "true" PCoA aneurysms were ruptured, demonstrating that true posterior communicating artery aneurysms are more prone to rupture (6,14).…”

Section: Discussionmentioning

confidence: 96%

Endovascular treatment of ruptured true posterior communicating artery aneurysms

Yang¹,

Su²,

Meng³

2014

Turkish Neurosurgery

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AIm: Although true posterior communicating artery (PCoA) aneurysms are rare, they are of vital importance. We reviewed 9 patients with this fatal disease, who were treated with endovascular embolization, and discussed the meaning of endovascular embolization for the treatment of true PCoA aneurysms. mATErIAl and mEThOds: From September 2006 to May 2012, 9 patients with digital substraction angiography (DSA) confirmed true PCoA aneurysms were treated with endovascular embolization. Patients were followed-up with a minimal duration of 17 months and assessed by Glasgow Outcome Scale (GOS) score.rEsulTs: All the patients presented with spontaneous subarachnoid hemorrhage from the ruptured aneurysms. The ratio of males to females was 1:2, and the average age of onset was 59.9 (ranging from 52 to 72) years. The preoperative Hunt-Hess grade scores were I to III. All patients had recovered satisfactorily. No permanent neurological deficits were left. CONClusION:Currently, endovascular embolization can be recommended as the top choice for the treatment of most true PCoA aneurysms, due to its advanced technique, especially the application of the stent-assisted coiling technique, combined with its advantage of mininal invasiveness and quick recovery. However, the choice of treatment methods should be based on the clinical and anatomical characteristics of the aneurysm and the skillfulness of the surgeon. BulGulAr: Tüm hastalar rüptüre anevrizmalardan spontan subaraknoid kanamayla geldi. Erkeklerin kadınlara oranı 1:2 şeklindeydi ve ortalama başlangıç yaşı 59,9 (52-72) yıldı. Preoperatif Hunt-Hess ölçeği puanları I ila III şeklindeydi. Tüm hastalar tatminkar şekilde iyileşmişti. Herhangi bir kalıcı nörolojik defisit yoktu. sONuÇ: Şu anda endovasküler embolizasyon, gelişmiş tekniği ve özellikle stent yardımlı sarmal tekniğinin uygulanması ve minimal invazivlik ve hızlı iyileşmeyle kombine avantajı sayesinde çoğu gerçek PCoA anevrizmasının tedavisinde en iyi tercih olarak önerilebilir. Ancak tedavi yöntemleri seçimi anevrizmanın klinik ve anatomik özellikleri ve cerrahın becerileri temelinde yapılmalıdır.

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“…7 Some have pointed out that as most ''true'' PCoA lesions occur within 2-3 mm of the PCoA origin, successful, safe cannulation of the aneurysm with a microcatheter might prove challenging, and the acuity of the approach angle may be too sharp to establish a stable microcatheter position, increasing the risk of possible coil extrusion into the parent vessel or intraprocedural rupture. 1 A ''true'' PCoA aneurysm has two access routes, from the anterior and posterior circulation, in endovascular treatment. We successfully occluded the parent artery using this combined approach of anterior and posterior circulation without premature re-bleed.…”

Section: Discussionmentioning

confidence: 99%

“…1 Two types of aneurysm described by Pia et al include the fusiform type without a definable neck and a saccular type. 2 In addition, it is believed that ''true'' PCoA aneurysms have a higher risk of rupture at small sizes compared with more traditional PCoA aneurysms.…”

Section: Introductionmentioning

confidence: 99%

Parent artery occlusion for ruptured “true” posterior communicating artery aneurysm

et al. 2015

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A case of a patient with a ruptured true posterior communicating artery (PCoA) aneurysm is reported, who had been managed by early endovascular parent artery occlusion with coils. The small blister aneurysm was located at the proximal PCoA itself and directed superiorly. Postoperative course was uneventful. During 1-month follow-up, the patient recovered well and could care for herself. Aneurysms of the PCoA itself are very rare. As reported to date, surgical procedures would favor microsurgical clipping over endovascular coil embolization. Endovascular treatment may be a good alternative to surgical trapping for true PCoA blister aneurysm.

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True Aneurysms of the Posterior Communicating Artery: A Systematic Review and Meta-Analysis of Individual Patient Data

Cited by 54 publications

References 58 publications

Stent-Assisted Coil Embolization of Posterior Communicating Artery Aneurysms

Stent-Assisted Coil Embolization of Posterior Communicating Artery Aneurysms

Endovascular treatment of ruptured true posterior communicating artery aneurysms

Parent artery occlusion for ruptured “true” posterior communicating artery aneurysm

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