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Recurrence and risk factors of posterior communicating artery aneurysms after endovascular treatment

 Min Jeoung Kim  ;  Joonho Chung  ;  Keun Young Park  ;  Dong Joon Kim  ;  Byung Moon Kim  ;  Sang Hyun Suh  ;  Jae Whan Lee  ;  Seung Kon Huh  ;  Yong Bae Kim  ;  Jin Yang Joo  ;  Nak Hoon Son  ;  Chang Ki Jang 
 ACTA NEUROCHIRURGICA, Vol.163(8) : 2319-2326, 2021-08 
Journal Title
Issue Date
Endovascular treatment ; Fetal-type Pcom ; Posterior communicating artery aneurysm ; Raymond–Roy classification ; Recanalization ; Reinforcement
Background: Endovascular treatment (EVT) of posterior communicating artery aneurysms (PcomA) is challenging because of posterior communicating artery (Pcom) architecture. Additionally, these aneurysms have a high risk of recanalization compared with those located elsewhere.

Methods: The radiographic findings of 171 patients treated with EVT at two institutions were retrospectively reviewed. Univariate and multivariate analyses were performed, and subgroup analyses were performed based on Pcom characteristics.

Results: Recanalization of PcomAs occurred in 53 patients (30.9%). Seven patients (4.0%) were retreated (six endovascularly and one with microsurgical clipping). The mean follow-up duration was 27.7 months (range: 3.5-78.6). The maximum diameter (odds ratio [OR] 1.23, P = .006, 95% CI 1.07-1.44), a Raymond-Roy classification of grade II or III (OR 2.26, P = .03, 95% CI 1.08-4.82), and the presence of reinforcement (balloon or/and stent, OR 0.44, P = .03, 95% CI 0.20-0.91) were associated with recanalization using multivariate logistic regression. Significant differences were found in maximum aneurysm diameter (P = .03) between normal- and fetal-type Pcoms on analysis of variance.

Conclusions: The recanalization rate of PcomAs after EVT was 30.9%; the retreatment rate was 4.0%. Maximum diameter, Raymond-Roy classification, and presence of reinforcement were significantly associated with recanalization but not associated with fetal-type Pcom. Aneurysm size was larger in patients with a fetal-type Pcom than in those with a normal Pcom. Pcom size was not related to recanalization rate.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Min Jeoung(김민정)
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0003-2262-7157
Park, Keun Young(박근영)
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Lee, Jae Whan(이재환)
Jang, Chang Ki(장창기) ORCID logo https://orcid.org/0000-0001-8715-8844
Chung, Joon Ho(정준호)
Joo, Jin Yang(주진양)
Huh, Seung Kon(허승곤)
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