A novel proximal end stenting technique for assisting embolization of a complex true posterior communicating aneurysm

Yang, Zhigang; Liu, Jianmin; Ge, Jiajia; Li, Zifu; Tian, Chunou; Han, Junyong; Zhao, Rui; Hong, Bo

doi:10.1016/j.jocn.2015.09.025

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…True PCoA aneurysms originating from the PCoA itself were considered rare and have been described in case reports [ 4 , 9 , 11 , 17 , 25 , 32 , 33 ]. In a systematic review, the incidence of such aneurysms was revealed as 1.3% among intracranial aneurysms and 6.8% among PCoA aneurysms [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

True Posterior Communicating Artery Aneurysms with High Risk of Rupture despite Very Small Diameter

Shin

Park

Kim

et al. 2022

J Korean Neurosurg Soc

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Objective : This retrospective study investigated the clinical and angiographic characteristics of ruptured true posterior communicating artery (PCoA) aneurysms in comparison with junctional PCoA aneurysms presenting with a subarachnoid hemorrhage.Methods : The medical records and radiological data of 93 consecutive patients who underwent three-dimensional rotational angiography and surgical or endovascular treatment for a ruptured junctional or true PCoA aneurysm over an 8-year period were examined.Results : The maximum diameter of the ruptured true PCoA aneurysm (n=13, 14.0%) was significantly smaller than that of the ruptured junctional PCoA aneurysms (n=80, 4.45±1.44 vs. 7.68±3.36 mm, p=0.001). In particular, the incidence of very small aneurysms <4 mm was 46.2% (six of 13 patients) in the ruptured true PCoA aneurysm group, yet only 2.5% (two of 80 patients) in the ruptured junctional PCoA aneurysm group. Meanwhile, the diameter of the PCoA was significantly larger in the true PCoA aneurysm group than that in the junctional PCoA aneurysm group (1.90±0.57 vs. 1.15±0.49 mm, p<0.001). In addition, the ipsilateral PCoA/P1 ratio was significantly larger in the true PCoA aneurysm group than that in the group of a junctional PCoA aneurysm (mean PCoA/P1 ratio±standard deviation, 2.67±1.22 vs. 1.14±0.88; p<0.001). No between-group difference was identified for the modified Fisher grade, clinical grade at admission, and 3-month modified Rankin Scale score.Conclusion : A true PCoA aneurysm was found to be associated with a larger PCoA and ruptured at a smaller diameter than a junctional PCoA aneurysm. In particular, the incidence of a ruptured aneurysm with a very small diameter <4 mm was significantly higher among the patients with a true PCoA aneurysm.

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Section: Discussionmentioning

confidence: 99%

True Posterior Communicating Artery Aneurysms with High Risk of Rupture despite Very Small Diameter

Shin

Park

Kim

et al. 2022

J Korean Neurosurg Soc

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“…1 The literature on endovascular management of such lesions is limited and the angiographic follow-up rate is considerably lower ( Table 3). [11][12][13][14][15][16][17][18][19] We retrospectively reviewed a series of eight TPCoA aneurysms in our database to assess the safety and efficacy of endovascular treatment in such cases. In this study, most of the treated TPCoA aneurysms were ruptured (7/8, 85.7%).…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, endovascular treatment has been widely used in management of intracranial aneurysms and such strategy in managing TPCoA aneurysms is reported in a few case studies. [11][12][13][14][15][16][17][18][19] Munarriz et al 12 reported a case of successful endovascular coiling of a TPCoA aneurysm with subsequent angiographic stability. Another report from Guo et al 11 showed three such aneurysms, of which two were treated endovascularly without complications.…”

Section: Discussionmentioning

confidence: 99%

“…Young et al 25 reported two PCoA aneurysms treated with retrograde stent placement from the terminal ICA to PCoA. Yang et al 19 showed a stent-assisted coiling case with the proximal end of the stent protruded into the fetal PCA. It seems to be a good alternative for TPCoA aneurysms treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Given the low incidence of TPCoA aneurysms, only limited small endovascular experiences are available in the literature. [11][12][13][14][15][16][17][18][19] To the best of our knowledge, only 19 total endovascularly treated cases are published in the literature with only six cases followed angiographically. The safety and efficacy of endovascular therapy for TPCoA aneurysm are still unclear based on limited cases.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of true posterior communicating artery aneurysms: Endovascular experience in a single center

Liu

Wang

et al. 2019

Interv Neuroradiol

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Background and objective The true posterior communicating artery (TPCoA) aneurysms are rare and endovascular treatment for such lesions is limited in literature. Methods From January 2012 to March 2017, eight TPCoA aneurysms were treated endovascularly and included in our present study. The procedural complication and outcomes were assessed. Results Seven of eight aneurysms (87.5%) were ruptured. Stent-assisted coiling was used in one case that a stent was deployed via PCoA-ipsilateral P2 segment. The dual-microcatheter technique was used in one case. The remaining six cases were treated by coiling alone. One patient (12.5%) suffered perioperative complication, of which a coil herniated into parent vessel during the procedure without symptomatic stroke or other adverse event after the procedure. The initial embolization results showed complete occlusion in five cases and residual neck in three. Six patients (75%) had a mean of 15-month angiographic follow-up and two of them revealed recurrence (33.3%). Clinical follow-up was available in seven patients (87.5%) and all patients showed favorable clinical outcome with mRS score 0. Conclusion TPCoA aneurysms are rare and challenging lesions with high rupture rate in literatures. Endovascular treatment may be a feasible alternative for TPCoA aneurysms. Primary coiling, as well as adjunctive strategies, such as stent-assisted coiling or dual catheter techniques may be considered. Further study in a larger population is necessary.

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Feasibility and midterm outcomes of endovascular embolization for true posterior communicating artery aneurysms

et al. 2019

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A novel proximal end stenting technique for assisting embolization of a complex true posterior communicating aneurysm

Cited by 5 publications

References 7 publications

True Posterior Communicating Artery Aneurysms with High Risk of Rupture despite Very Small Diameter

True Posterior Communicating Artery Aneurysms with High Risk of Rupture despite Very Small Diameter

Treatment of true posterior communicating artery aneurysms: Endovascular experience in a single center

Feasibility and midterm outcomes of endovascular embolization for true posterior communicating artery aneurysms

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